title: The relationship between pay day and violent death in Guatemala: a time series analysis.
abstract: To assess if violent deaths were associated with pay days in Guatemala.
  
  
  
  Interrupted time series analysis.
  
  
  
  Guatemalan national autopsy databases.
  
  
  
  Daily violence-related autopsy data for 22 418 decedents from 2009 to 2012. Data were provided by the Guatemalan National Institute of Forensic Sciences. Multiple pay-day lags and other important days such as holidays were tested.
  
  
  
  Absolute and relative estimates of excess violent deaths on pay days and holidays.
  
  
  
  The occurrence of violent deaths was not associated with pay days. However, a significant association was observed for national holidays, and this association was more pronounced when national holidays and pay days occurred simultaneously. This effect was observed mainly in males, who constituted the vast majority of violent deaths in Guatemala. An estimated 112 (coefficient=3.12; 95% CI 2.15 to 4.08; p<0.01) more male violent deaths occurred on holidays than were expected. An estimated 121 (coefficient=4.64; 95% CI 3.41 to 5.88; p<0.01) more male violent deaths than expected occurred on holidays that coincided with the first 2 days following a pay day.
  
  
  
  Men in Guatemala experience violent deaths at an elevated rate when pay days coincide with national holidays. Efforts to be better prepared for violence during national holidays and to prevent violent deaths by rescheduling pay days when these days co-occur with national holidays should be considered.
authors.affiliation: Facultad de Ciencias Médicas, Centro de Investigaciones de las Ciencias de la Salud, Universidad de San Carlos de Guatemala, Guatemala, Guatemala.
authors.forename: Dorian E
authors.identifier: 0000-0003-1952-2012
authors.initials: DE
authors.lastname: Ramírez
authors.affiliation: Penn Injury Science Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Branas
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Therese S
authors.initials: TS
authors.lastname: Richmond
authors.affiliation: Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Kent
authors.initials: K
authors.lastname: Bream
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
authors.affiliation: Facultad de Ciencias Médicas, Centro de Investigaciones de las Ciencias de la Salud, Universidad de San Carlos de Guatemala, Guatemala, Guatemala.
authors.forename: Magda
authors.initials: M
authors.lastname: Velásquez-Tohom
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Wiebe
mesh_terms: D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006693:Holidays / Q000523:psychology; D006708:Homicide / Q000208:ethnology / Q000706:statistics & numerical data*; D006801:Humans; D065186:Interrupted Time Series Analysis; D008297:Male; D011159:Population Surveillance; D012456:Salaries and Fringe Benefits; D017678:Sex Distribution; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014754:Violence / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000208:ethnology / Q000401:mortality*