Human Trafficking: Responses By the Public Health and Health Care Sectors

The purpose of this dissertation project was to explore the public health and health care sector responses to the trafficking of adults for labor and sex. Ninety public health, health care, and victim service providers from the Houston metropolitan area participated in semi-structured interviews between June 2015 and February 2016. Two articles were written based on this data. Findings suggested ways by which public health and health care can improve health care outcomes for trafficked people and mitigate human trafficking.

The first article, public health responses to human trafficking, focused on the actions of three Houston area local public health departments towards the trafficking of adults in their jurisdictions. Case study methodology was employed and 65 of the 90 participants informed the study. Analysis involved construction of a detailed narrative description of the area public health departmental responses to trafficking. Results suggested that all three departments were in the nascent stages of determining a potential response to trafficking. City Health, through its somewhat longer engagement in city-wide anti-trafficking efforts, demonstrated promising practices. Although the authors believed that public health departments have much to offer anti-trafficking efforts, such as development of intervention strategies to prevent and mitigate the factors that can make groups vulnerable to trafficking, findings suggested that with the financial constraints under which these departments operate, additional dedicated funding might be needed for them to be able to engage extensively in anti-trafficking efforts. Future research might look to how other public health departments respond to human trafficking and use the data to build a conceptual framework for a model public health departmental response to human trafficking.

The second article, health care sector responses to human trafficking, focused on challenges health care practitioners encountered in identifying currently trafficked adult victims who presented for medical attention in health care settings. Thematic content analysis of 44 transcribed interviews with health care professionals was employed to identify salient themes. Several factors were identified including provider: lack of knowledge and training on human trafficking; stereotypes of stigmatized populations; apprehension about the existence of adequate community resources to assist identified victims; and uncertainty about how to care for victims and where to safely refer them in the absence of institutional infrastructure and guidance. These findings supported extant literature calling for the development of institutional identification and response protocols with streamlined mechanisms of referral to vetted community resources able to assist victims. Findings also suggested that training to improve victim identification include content and teaching modalities that promote awareness of the impact of stereotypes on effective patient interaction and the ability to differentially diagnose victims of trafficking versus other stigmatized populations. Future research might look to best practices in training health professionals to work with other stigmatized groups such as undocumented immigrants, sex workers, and patients with HIV or mental illness, and evaluating these for use with trafficked people.