Power of framing: Re-thinking a public health response to modern slavery

Human trafficking is a recognized, harrowing problem. Over 17,000 persons are brought into the U.S. yearly for labor or sexual exploitation, and an additional 100,000 teens trafficked for sex domestically. Victims are at extreme risk for injury, psychological trauma, HIV infection, substance abuse, and death. Health professionals are instrumental to rescue and rehabilitation, but efforts remain nascent and disjointed. My research reviewed the evidence on health needs and access among victims and survivors, and critically examined U.S. policy and public health planning. Results revealed conspicuous paucity of information on victim needs. Such gaps are linked to a policy context where anti-trafficking efforts are couched in priorities of law-enforcement and border-policing priorities. This approach does not serve the persons who are subject to violence, sexual assault, and exploitation – nor has it stopped trafficking. Rather, it is embedded in a specific historical and political context, which assumes a nationality-based definition of personhood, and fails to address the structural drivers of exploitation. I propose a public health framework for anti-trafficking efforts, focusing on risk factors across the victim's life-stages; mechanisms by which violence is perpetuated; and opportunities for resilience and prevention. Such a framework shifts towards a human-rights-based definition of personhood and a socio-ecological understanding of health. Programmatically, efforts can be modeled on the CDC's Violence Prevention initiatives, and linked to a national data repository. We must move to connect community advocates, researchers, providers, and policy-makers; render the “invisible” victims countable; and produce evidence-based interventions for measurable impacts against enslavement and suffering.