Practice of Medicine

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Identifying and Responding to Human Trafficking

By: Jordan Greenbaum, MD

Human trafficking is a significant public health issue and many trafficked persons are likely to present to healthcare professionals with a variety of health problems. It is imperative for healthcare organizations to be educated about human trafficking, identify risk factors and potential indicators and respond appropriately. 

Recommended Actions 

  • Educate staff regarding the signs of human trafficking so they are prepared to identify indicators and respond in an appropriate manner. 
  • Consider utilizing online resources on human trafficking to raise awareness among health professionals and increase their ability to recognize potential victims and respond appropriately. 

Human trafficking involves the engagement of a person in labor or sexual exploitation using force, fraud or coercion. It is a significant public health issue that is associated with numerous adverse physical and behavioral health effects. Research suggests that healthcare professionals are likely to encounter child and adult victims during the course of their practice. In a recent study, almost 90% of sex trafficking survivors reported seeking medical services at some point during their victimization.1 

Trafficked persons may present to emergency departments or clinics, to primary care or specialty care physicians, and to mental health providers. Common health problems include acute physical or sexual assault, sexually and non-sexually transmitted infections, pregnancy-related issues, depression, suicidality, substance misuse and symptoms of post-traumatic stress disorder. 

It is critical that medical and behavioral health professionals are educated about human trafficking so they can identify risk factors and indicators and respond in a situationally and culturally appropriate manner. Yet many practitioners have received little or no education on trafficking and feel poorly prepared to recognize and assist victims. There is a need for a centralized resource for healthcare professionals to obtain high-quality education about human trafficking, as well as critical technical assistance to develop protocols and implement changes in practice.  

The Institute for Healthcare and Human Trafficking (IHHT) assists medical and behavioral health professionals seeking information on all types of human trafficking (labor/sex; children/adults; domestic/international). The goals of IHHT are: 1) to raise awareness among health professionals about human trafficking; 2) to increase the ability of professionals to recognize potential victims and respond appropriately; and 3) to contribute to the body of research on human trafficking.  

IHHT offers the following: 

  • Online resources2 for health professionals that includes research articles, sample protocols, fact sheets, patient information sheets and other information 
  • Free onsite training for medical and behavioral health professionals to help staff develop the skills needed to recognize and intervene in cases of suspected human trafficking. The training includes a one-hour presentation with free CME/CNE credits; the session may be offered multiple times at large organizations to accommodate staff members. 
  • Free technical assistance for hospital or clinic staff to develop guidelines and protocols for responding to suspected human trafficking 

Lessons Learned:  

  • Provide healthcare staff with educational resources including research articles and fact sheets aimed at identifying and responding appropriately to human trafficking. 
  • Consider implementing a facility protocol for handling a suspected human trafficking event and assisting victims. 
  • Stay up-to-date with federal, state and local laws regarding the obligation to report suspected cases of human trafficking.  

Potential Damages 

Although federal law does not currently mandate human trafficking reporting by healthcare providers for patients 18 and over, providers who participate in federal government reimbursement programs are required to report suspected child abuse to an appropriate agency when they learn of facts to suspect that a child has suffered an incident of child abuse, including human trafficking. Healthcare providers who fail to report suspected human trafficking occurrences may risk state legal action.  The frequency of such issues is relatively low, reflecting the fact that expectations to report human trafficking are still developing.  

Quiz 

Answers are provided below 

True or false?  

Question 1: Healthcare professionals are likely to encounter the victims of human trafficking. 

Question 2: Most healthcare practitioners are properly educated and prepared to recognize human trafficking and assist victims. 

Question 3: The Institute for Healthcare and Human Trafficking assists medical and behavioral health professionals with all types of human trafficking. 

Answers 

Question 1: True. A majority of sex trafficking survivors reported seeking medical services during their victimization, including presenting to emergency departments or clinics, to primary care or specialty care physicians, and to mental health providers. 

Question 2: False. Many practitioners have received little education on human trafficking, yet it is critical that healthcare professionals are educated and prepared to identify indicators and respond in a situationally and culturally appropriate manner.  

Question 3: True. IHHT provides online resources, free onsite training for medical and behavioral health professionals, and free technical assistance for hospital or clinic staff to develop guidelines and protocols concerning suspected human trafficking. 

1 Lederer LJ, Wetzel CA. The health consequences of sex trafficking and their implications for identifying victims
in healthcare settings. Annals of Health Law. 2014;23:61-91.

2 https://www.choa.org/medical-professionals/referrals-and-transfers/directory-of-services/child-protection-
resources/institute-on-healthcare-and-human-trafficking

01/23

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Disclaimer

The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.