Is Your Patient a Victim of Human Trafficking?

Most healthcare practitioners are aware they have a responsibility to identify and report victims of abuse, neglect, and domestic violence. Another type of abuse—human trafficking—is, however, on the rise in every state throughout the nation. The National Human Trafficking Hotline statistics for 2023 include 9,619 cases reported, with 16,999 victims.

According to the U.S. Department of State’s 2024 Trafficking in Persons Report, technology has had an increasing impact on human trafficking. Although digital tools such as dating apps and online advertising have made it easier to recruit and defraud victims, technology has also made it easier to find and assist victims through mobile phones, social media, and artificial intelligence data analysis.

Human trafficking is a federal crime with severe penalties. The Trafficking Victims Protection Act of 2000 provides tools to address human trafficking on a national and worldwide level. Many states also have laws and penalties for human trafficking.

The crime occurs when a trafficker uses force, fraud, or coercion to make a person perform labor or sexual acts against the individual’s will. Victims can be any age (adults or minors), any gender, and from any cultural or ethnic group. The trafficker—or abuser—might be a stranger, a family member, or a friend. Trafficking, a profitable criminal industry, generates billions of dollars worldwide. Lack of awareness and misconceptions can allow opportunities for identifying victims to go unnoticed and unreported.

Although trafficking victims rarely find opportunities to interact with others without approval from the abuser, research shows that an overwhelming majority of victims see a medical or dental professional during captivity. A visit to a medical or dental practice provides a rare opportunity for an individual to receive help.

Recognizing Victims

Victims are usually afraid to seek help for reasons that stem from fear, shame, or language barriers. Medical and dental practitioners and their staff should be trained to recognize the signs of human trafficking and know what steps to take.

Human trafficking victims are commonly seen in medical and dental practices with the following physical conditions:

• Acute or signs of long-term trauma, such as broken bones, bruises, scars, burn marks, or missing teeth.
• Poor physical and dental hygiene.
• Gynecological trauma, multiple sexually transmitted infections, or multiple pregnancies.
• Anxiety, depression, or insomnia.
• Malnourishment.
• Substance use.
• Suspicious tattoos or branding.

Human trafficking victims may exhibit the following behavioral red flags:

• Fearful.
• Depression or flat affect.
• Submissive to the partner or relative accompanying them.
• Lack of control over personal identification or finances.
• Not allowed to speak for himself or herself.
• Reluctance or inability to verify address or contact information.
• Unwilling to provide details about the injury or illness.
• Inconsistency with any information provided (medical, social, family, etc.).

Because victims may be fearful and distrustful of their environment, it is best not to ask individuals direct questions about being a victim of human trafficking. The following questions can help in identifying victims:

• Has anyone threatened you or your family?
• Can you leave your job or home if you want to?
• Are there locks on your doors and windows to keep you from leaving?
• Do you have to get permission to eat, sleep, or use the restroom?
• Has someone taken your personal documents or identification?

Patient Safety Strategies

The following strategies can help you take action to protect patients:

• Call 911 if you suspect that someone is in immediate danger. If you suspect that a patient is a victim of human trafficking, contact the National Human Trafficking Hotline:

Call: (888) 373-7888

Text: 233733

Email: help@humantraffickinghotline.org

Online Report: humantraffickinghotline.org/report-trafficking

• Report as required by state law regarding mandatory reporting of patient abuse or neglect situations.
• Report as required by state law regarding human trafficking. All states require reporting of child trafficking but may not require reporting for adults. While the HIPAA Privacy Rule allows the disclosure of protected health information without authorization in some circumstances—such as imminent danger—contact your risk manager or legal counsel if you are in doubt. Unless calling the authorities is mandatory or impending danger is suspected, it is best not to do so without the patient’s permission.
• Implement practice protocols that outline a process for recognizing the signs of human trafficking and taking action. (See HEAL Trafficking and Hope for Justice’s Protocol Toolkit for Developing a Response to Victims of Human Trafficking in Health Care Settings.)
• Provide staff training. Nonclinical staff is usually the first point of contact for patients in healthcare settings. When properly trained, staff can identify behavioral red flags that may indicate a patient is a victim of human trafficking and alert a clinical staff member. Staff training opportunities should include role-playing scenarios for various human trafficking situations. “The PEARR Tool,” developed by CommonSpirit Health in partnership with HEAL Trafficking and Pacific Survivor Center, is a valuable guide for healthcare professionals on how to provide trauma-informed assistance to at-risk patients.
• Display patient information. The National Human Trafficking Hotline website has downloadable awareness materials, including posters and wallet cards in multiple languages. Provide printed resources in areas where they can be discretely accessed by patients.

Contact Us

Your patient safety risk manager can help if you have questions. Contact us at (800) 421-2368 or by email.