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From the President: Emerging Issues

 Human Trafficking and Access to Health Care

By Atyya Chaudhry, MPPAtyya-Chaudhry-FINAL.jpg
Policy Analyst, Health Reform Implementation, AMCHP

Human trafficking takes many forms, ranging from forced prostitution to exploitation of laborers. Because of the various forms of human trafficking, anyone can be affected, including the populations primarily served by Title V programs: women, children, adolescents, and their families. The nature of human trafficking makes it difficult to monitor - victims may be trafficked internationally into the U.S. and vice versa, across state lines, or even locally. The National Human Trafficking Resource Center (NHTRC) operates a 24/7 toll-free national hotline in the United States and monitors the number of calls received. In 2015, they received 21,947 calls with 5,544 cases of human trafficking reported. According to the U.S. Department of State, an estimated 18-20,000 individuals are trafficked into the U.S. annually. The actual number of domestic and international victims in the U.S. may vary. 

The Trafficking Victims Protection Act (TVPA) of 2000 made human trafficking a federal crime. The TVPA was legislated to prevent "severe" forms of human trafficking, protect victims in the U.S. and abroad, and prosecute offenders. "Severe" forms of human trafficking are defined as:

  • Sex trafficking [i.e., the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act] in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age; or
  • The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

There are several initiatives to prevent and combat human trafficking at the federal level across departments and agencies, including interagency initiatives. Collaboration across departments is critical in identifying and aiding trafficked victims. Under the U.S. Department of Health and Human Services, the Administration of Children and Families (ACF) operates a newly created Office on Trafficking in Persons that administers an Anti-Trafficking in Persons Grant program. As of 2015, grants were awarded to grantees in all ten HHS regions. A full list of grantee information by state with contact information can be found here.

While there is no one size fits all strategy to address human trafficking, in the past few years, access to health care has emerged as one strategy. Contact with a health care provider may often be the only time a trafficked victim is alone and in safe space. In a 2014 study on victims of sex trafficking, approximately 87.8 percent of victims indicated they had contact with some form of health care while being trafficked. In light of the role health care professionals can play as frontline responders, the American Medical Association released a policy encouraging members to raise awareness about the issue and the resources available. In addition, Futures without Violence has resources for providers and organizations to better understand and address this problem, building a healthcare response and the role of the healthcare provider

Title V programs are well positioned to increase access to health care through outreach, enrollment, and education about coverage options in Medicaid, the Children's Health Insurance Program (CHIP), the health insurance Marketplace, and local health care clinics. The well-woman visit, adolescent well-visit, and adequate insurance National Performance Measures (NPMs) are all tied to access to health care. Movement in these NPMs may positively impact the lives of trafficked victims. Title V programs are also well positioned to work collaboratively across agencies and partners to increase awareness, understanding, and improve collective response. In Tennessee, for example, MCH staff collaborate with the Tennessee Bureau of Investigation and the Departments of Human Services, Children's Services, Intellectual and Developmental Disabilities, and Mental Health in a coordinated system of identification and service delivery for human trafficking victims. Addressing human trafficking at the state level is truly a cross-agency collaboration; there are several resources and grantees at the national, state, and local level that Title V programs can connect with to help address this issue that affects some of the most vulnerable MCH populations.