Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.


July 30, 2018

How Northwell, Dignity, and other top systems are finding—and helping—human trafficking victims

Daily Briefing

    A growing number of health care systems and hospitals are launching programs designed to identify and support human trafficking victims, Michelle Andrews reports for Kaiser Health News.  

    The programs are emerging as health care providers beginning in October will be able to use new diagnosis codes in their records to distinguish trafficking from other kinds of abuse. The new diagnosis codes are intended to help track and treat victims of human trafficking.

    Get resources to identify and address health inequity in your community


    Human trafficking is term that describes people forced to work or have sex for another person's commercial benefit. No hard data exist on the number of people who are victims of human trafficking, but Polaris, a nonprofit that works to help the victims of human trafficking, said texts and calls to its national hotlines increased by 13% between 2016 and 2017, to 8,759.

    A 2014 survey of about of 100 survivors of sex trafficking found 88% of survivors said they had contact with a health care provider—usually someone in an ED—while they were being trafficked. However, health care providers regularly fail to identify victims of human trafficking.

    Health care providers take steps to identify human trafficking victims

    Northwell Health, a health care system with 23 hospitals, is one of many health care systems and hospitals offering training to their employees—including nurses, physicians, reception staff, social workers, and security guards—on how to detect and help human trafficking victim.

    Santhosh Paulus, a family physician and the site director of Huntington Hospital's family medicine residency program at Northwell, said, "When trafficking victims come through the health care system, but we don't identify them, it's a big missed opportunity."

    To train staff, Huntington Hospital coordinated with Restore NYC, an organization that helps victims of sex trafficking. Restore NYC provided initial training to key members of Huntington Hospital's staff on how to recognize human trafficking victims, and then a hospital task force provided training to the remainder of the staff.

    Overall, since last spring, about 300 Huntington Hospital employees have received the human trafficking response training. Paulus said Northwell over the next few years plans to roll out similar programs at all of Northwell's hospitals.

    Meanwhile, Dignity Health, a health care system with about 40 hospitals in Arizona, California, and Nevada, started establishing human trafficking response programs in each of its hospitals' EDs and labor delivery areas. Dignity released a manual last year that outlines recommendations to providers for spotting and helping victims of human trafficking, including:

    • Potential indicators of human trafficking in patients, such as fearful or submissive behavior, a controlling companion, or more subtle signs, such as a patient who does not know what city he or she is in;
    • Policies to respond to those indicators, including assessment questions;
    • Advice on how to cultivate trust with a patient and how to offer assistance;
    • Guidance on when to contact human trafficking response agencies; and
    • Recommendations on identifying relevant community services.

    In addition, Massachusetts General Hospital in 2008 launched an initiative to address human trafficking as a public health issue and "advance anti-trafficking efforts in research, education, policy, and clinical care within the health sector," Becker's Hospital Review reports. Catholic Health Initiatives also has launched several human trafficking prevention initiatives in Kentucky and Houston.

    How to spot human trafficking victims

    Wendy Macias-Konstantopoulos, the director of Massachusetts General Hospital's human trafficking initiative, said identifying human trafficking victims is similar to identifying victims of other types of violence.

    According to Macias-Konstantopoulos, one signal that a patient might be a victim is an unexplained delay in seeking medical care for an emergent condition. Other signals include "a pattern of injuries that [does not] make sense," a person's reluctance to explain his or her injury, and a person coming into a hospital with another person who appears overbearing. She said, "Having a high index of suspicion is the first step" in identifying patients who are victims of human trafficking. Macias-Konstantopoulos said, "If we're not asking about it, we're just not going to see it."

    However, Holly Gibbs, a survivor of human trafficking and a human trafficking response program director for Dignity Health, said asking patients questions regarding human trafficking might not always reveal the truth, because some patients are unwilling or prepared to acknowledge that they are being trafficked and need help. Gibbs explained that if patients do not want help, health care providers have to "respect their wishes." She said, "They may not be ready to accept help now, but you may plant seeds so they'll be able to accept it later on" (Andrews, Kaiser Health News, 7/24; Gooch, Becker's Hospital Review, 7/24).

    Using big data to stop human trafficking

    Big data is essential to finding and disrupting trafficking networks.

    Polaris, a nonprofit organization working to end human trafficking, enlisted the Advisory Board's data analysis expertise to create a system that connects the calls fielded by the National Human Trafficking Resource Center to the trafficking networks perpetrating these crimes.

    The partnership is resulting in game-changing outcomes for victims of human trafficking. Watch our video about the partnership and why it matters for providers today.

    Watch the Video

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.