The Disease Outbreak-Human Trafficking Connection: A Missed Opportunity

The Intersection of Human Trafficking and Natural Disasters: A Scoping Review

Natural disasters have increased in frequency and severity in recent years. Emerging research also suggests that natural disasters increase the risk of human trafficking. This confluence of phenomena makes it critically important to better prepare communities for preventing and responding to human trafficking during and after a natural disaster. Yet, there is no available synthesis of the extant research to inform these preparations. The present scoping review aims to fill this gap by outlining the existing literature on the nexus of disasters and human trafficking. The review follows the Preferred Reporting Items of Systematic Reviews and Meta-Analysis-Scoping Review guidelines. Sources were identified through manual reference checking and in four databases: PubMed, Web of Science, APA PsychINFO, and EBSCO Discovery Service. In total, 46 sources met the inclusion criteria, that is, they focused on the nexus between human trafficking and natural disasters, demonstrated scientific rigor, and were published after 2000 and in English. Overall, the reviewed literature provided initial evidence on the association between natural disasters occurrences and increases in national and transnational human trafficking activity, understanding of the compounding vulnerabilities conducive to trafficking following disasters, and recommendations for the prevention and response to human trafficking in the wake of disasters. Future studies should evaluate prevention initiatives, including awareness campaigns and interventions that mitigate trafficking vulnerabilities. In practice, it is crucial to integrate anti-trafficking efforts into disaster relief protocols, empower vulnerable populations, and advocate for enhanced legal protections for displaced and migrant individuals.

Increased Emergency Department Identification of Young People Experiencing Trafficking During the COVID-19 Pandemic: An Interrupted Time-Series Analysis

OBJECTIVE

Human trafficking is a public health issue affecting young people across the United States, and trafficked young people frequently present to emergency departments (EDs). The identification of trafficked young people by pediatric EDs during the COVID-19 pandemic is not well understood. We examined trends in the identification of young people with current or lifetime experiences of trafficking in US pediatric EDs before and during the COVID-19 pandemic.

METHODS

We performed an interrupted time-series analysis using the Pediatric Health Information System database, which includes data from 49 US children's hospitals, to determine differences in rates of trafficked young people identified in pediatric EDs before and during the COVID-19 pandemic.

RESULTS

We included 910 patients; 255 prepandemic (October 1, 2018, through February 29, 2020) and 655 during the COVID-19 pandemic (March 1, 2020, through February 28, 2023). We found a 1.92-fold increase in the incidence rate of identified trafficked young people at the start of the COVID-19 pandemic in March 2020 (incidence rate ratio = 1.92; 95% CI, 1.47-2.51; P < .001), followed by a decrease over time.

CONCLUSIONS

The observed increase in identified trafficked young people during the onset of the COVID-19 pandemic should alert pediatric ED providers to the opportunity to identify and provide services for trafficked young people as an important part of improving preparedness for future disease outbreaks. Our observed identification trends do not represent the true incidence of trafficked young people presenting to pediatric EDs during the COVID-19 pandemic. Future work should seek to better understand the true occurrence and the health and service needs of trafficked young people during emergencies.

COVID-19 and Child Sex Trafficking: Qualitative Insights on the Effect of the Pandemic on Victimization and Service Provision

OBJECTIVES

Child sex trafficking (CST) is the involvement of minors in the commercial exchange of sex for goods, services, drugs, or money. The COVID-19 pandemic negatively affected many risk factors associated with CST victimization and the availability of CST services. We examined service providers' perspectives on how the pandemic affected trajectories of CST victimization among young people in the United States.

METHODS

We collected qualitative data from 80 law enforcement professionals and service providers working with young people affected by CST from 11 US cities. Semistructured interviews lasted approximately 1 hour and were digitally recorded, transcribed verbatim, and coded via a grounded theory approach.

RESULTS

We found 3 overarching themes related to the pandemic's effect on CST victimization trajectories: grooming, perpetration, and service provision. Participants described how increased online activity may have increased the risk of CST, even among children without traditional risk factors. However, technology also facilitated young people's agency in seeking help and receiving services. In addition, participants reported increases in virtual service provision that facilitated access to, and availability of, CST services more generally.

CONCLUSIONS

Technology use among young people increased during the pandemic, leading to increases in the risks of experiencing technology-facilitated CST. Technology use among young people who experience CST victimization-and how it may differ from young people more generally-is underexplored and may provide insights into prevention and treatment. Collectively, results highlight the need for epidemiologic research to help identify how global and national events affect trajectories of victimization among young people.

Modern slavery and labor exploitation during the COVID-19 pandemic: a conceptual model

BACKGROUND

Modern slavery is a complex global health problem that includes forced labor exploitation. An ecological systems perspective is needed to understand how contextual upstream and midstream factors contribute to labor exploitation, and how disruptive societal challenges, such as infectious disease pandemics, may exacerbate established pathways leading to exploitation. Accumulation of familial and societal risk factors likely heightens vulnerability; for instance, economic precarity for an individual interacts with poor livelihood options and lack of social welfare supports increasing their likelihood of accepting exploitative labor. However, few frameworks exist that account for the accumulation of and interdependence between risk factors at different levels and across contexts.

OBJECTIVE

Using an ecological systems framework, we review literature on the pathways leading to labor exploitation, with the aim of developing a conceptual model grounded in existing research. Next, we discuss how pathways in this conceptual model are likely exacerbated by the COVID-19 pandemic. This conceptual model can guide future research to detect modifiable factors and strategic points of intervention.

METHODS

A critical review of research articles and gray literature was performed with a primary focus on sub-Saharan Africa. The review utilized various scholarly databases to identify perspectives from multiple disciplines and to more fully account for complex processes linked to labor exploitation.

RESULTS

A conceptual model of these pathways was developed that emphasizes established determinants and risk factors for labor exploitation in sub-Saharan Africa. The model highlights how the COVID-19 pandemic may have exacerbated these pathways.

CONCLUSIONS

Future studies should carefully examine the direct and indirect pathways, accumulation of and interactions between factors, and specific external and personal stressors. Interdisciplinary research on multilevel interventions is needed to guide solutions to prevent the persistent problem of labor exploitation.

The Public Health Impact of Coronavirus Disease on Human Trafficking

The global pandemic of severe acute respiratory syndrome coronavirus 2 exacerbates major risk factors for global human trafficking. Social isolation of families and severe economic distress amplify the risk of interpersonal violence, unemployment and homelessness, as well as increased internet use by under-supervised children. Aggravating the situation are overwhelmed health systems, severe limitations in activities of social service organizations, and decreased contact of healthcare professionals with children. Healthcare professionals have a duty to be alert to possible indicators of trafficking, and aware of available victim resources which can be offered to at-risk patients. Healthcare facilities should take steps to increase public awareness of trafficking and community resources.