Human Trafficking: A Public Health Perspective (excerpt from US TIP Report 2017)

Human trafficking is a crime increasingly associated with other government priorities such as national security, economic stability, migration, and environmental sustainability. It is reported that human trafficking fuels transnational criminal organizations, exacerbates irregular migratory flows, disrupts labor markets, and sustains other harmful, illicit activities through the forced criminality of its victims. Human trafficking can subvert legitimate economic and labor markets and cause a loss of productivity and economic stability for countries. And certain industries known for the use of forced labor also feature practices that wreak significant environmental damage.

In the public health arena, the consequences of human trafficking are even more evident. The circumstances that victims of human trafficking endure often include unsanitary and dangerous work environments, poor living conditions, substandard nutrition, exposure to sexually transmitted and other communicable diseases, and the denial of access to any health care. Victims of trafficking also frequently suffer physical and mental abuse resulting in physical, sexual, and psychological trauma.

For both children and adults, unsanitary and crowded living conditions, coupled with poor nutrition, foster a host of adverse health conditions. In forced labor cases, long hours and hazardous working conditions including poor training, proximity to dangerous chemicals, lack of personal protective equipment, and financial or physical punishment, including sexual assault, can cause or contribute injuries and illnesses. Sex trafficking victims are exposed to pelvic inflammatory disease, HIV/AIDS, and other sexually transmitted infections. Human traffickers may force pregnant victims to undergo abortions, usually in unsafe conditions, posing further trauma and health risks. In addition to physical harm suffered, the range of recurrent emotional and psychological abuse victims often experience can lead to a host of disorders, such as anxiety, depression, and panic attacks.

The myriad health conditions victims of human trafficking face are often not treated properly or promptly, if at all. Victims may be barred entirely from seeking medical attention for health issues and from seeking preventive services, such as dental cleanings, annual health screenings, or vaccinations, either by their trafficker or due to a lack of health insurance or money. Unaddressed health issues, which may have been treatable if detected early, can become more aggressive and severely degenerate the individual’s health. Even after leaving a trafficking situation, survivors face health risks and consequences that last for many years. These often chronic health conditions are compounded for survivors of trafficking by unique barriers to accessing adequate health care and medical treatment. Untreated conditions, especially contagious illnesses, can threaten the health of the individual victims, as well as the collective health condition of their communities.

In responding to the consequences detailed above, several U.S. public health experts in the 2017 compilation of essays titled Human Trafficking Is a Public Health Issue make the case that using a public health perspective that moves beyond a criminal justice response has the advantage of enlisting a broader set of stakeholders and leads to more effective strategies to support victims and prevent human trafficking. For example, licensed health care practitioners, first responders, and other service providers can be trained to better identify victims seeking medical attention and help them to come forward. Likewise, professional curricula on domestic violence, child abuse, and elder abuse can integrate human trafficking elements. Such enhanced understanding and expanded training among a wide range of community stakeholders also aids in the prevention of human trafficking, as individuals with certain histories—such as abuse, violence, homelessness, substance abuse, or untreated mental health disorders—are considered at increased risk for human trafficking. In this way, employing a public health perspective can help inform the development of more effective anti-trafficking interventions and prevention strategies.

[Page 18 from the U.S. TIP Report, June 2017.]