257728 Power of framing: Re-thinking a public health response to modern slavery

Tuesday, October 30, 2012

Hana Akselrod, MPH, MD Candidate , Department of Medicine, Mount Sinai School of Medicine, New York, NY
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.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Program planning
Provision of health care to the public
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Attendees will be able to (1) analyze and deconstruct the U.S. response to the public health and medical challenges presented by realities of human trafficking; and (2) formulate a more nuanced plan for addressing the needs of victims and survivors, based in the socio-ecological model of health and connected to the CDC’s Violence Prevention framework.

Keywords: Sexual Assault, Violence Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: While studying at Mount Sinai School of Medicine, in 2009, I co-organized the first CME workshop on identifying victims of human trafficking in NYC. I continued to research the epidemiology and policy context of trafficking as part of my MPH work at Yale School of Public Health in 2011-2012. Previously, I have written my undergraduate thesis in medical anthropology, and worked on evidence-based advocacy projects with Physicians for Human Rights and Partners In Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.