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Edgemon TG, Clay-Warner J, Kawashima T, Anarfi JK, Okech D. Violence Increases Psychological Distress Among Women Trafficking Survivors in Ghana. Violence Against Women 2024:10778012241231780. [PMID: 38332619 DOI: 10.1177/10778012241231780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Human trafficking is a crime that is often shaped by violence, particularly for women who are trafficked. Additionally, trafficking survivors often report severe psychological distress, though research on the causes of this psychological distress is lacking, as there is little longitudinal data available on trafficking survivors. Informed by past literature on the links between violence and mental health among other traumatized groups of women, we investigate how experiences of violence influence posttraumatic stress, depression, and suicide ideation among a unique longitudinal sample of 116 labor-trafficked women in Ghana. We find that experiencing sexual violence while being trafficked is associated with higher levels of both depression and posttraumatic stress years after the trafficking period ended. This indicates both the long-term effects of stress and the enduring nature of psychological distress among the women in this study. Our analytic account of how violent experiences while trafficked impact mental health over the period of reintegration contributes to the general literature on violence and mental health among women, as well as to literature on the health implications of human trafficking.
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Affiliation(s)
- Timothy G Edgemon
- Department of Sociology, Social Policy, and Criminology, University of Birmingham, Birmingham, UK
| | | | | | - John K Anarfi
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - David Okech
- School of Social Work, University of Georgia, Athens, GA, USA
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2
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García-Vázquez O, Meneses-Falcón C. What is the Impact of Human Trafficking on the Biopsychosocial Health of Victims: A Systematic Review. J Immigr Minor Health 2024; 26:148-162. [PMID: 37222868 DOI: 10.1007/s10903-023-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
The health consequences of human trafficking have been poorly researched compared to other aspects of this crime. A systematic review was carried out to study health from a broader perspective, beyond psychophysical symptoms, to understand the global impact of human trafficking on sexual, social, physical, and psychological health. The search identified many studies focused on the violence of sex trafficking in female samples. This work leads us to conclude that social health is an important dimension of the well-being of trafficking victims. More studies are needed on aspects of social health, especially regarding research gaps related to spirituality and nutrition, thus continuing preventing and combating human trafficking. Many gender biases were also discovered: unlike studies of trafficking in women, the few studies on men did not look at parenting, sexual health, marital status, or sex trafficking.
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Affiliation(s)
- Olaya García-Vázquez
- University Institute of Studies on Migration, Comillas Pontifical University, Street Alberto Aguilera 23, 28015, Madrid, Spain.
| | - Carmen Meneses-Falcón
- Sociology and Social Work Faculty, Comillas Pontifical University, Street Universidad Comillas, 3-5, 28049, Madrid, Spain
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Aibangbee M, Micheal S, Mapedzahama V, Liamputtong P, Pithavadian R, Hossain Z, Mpofu E, Dune T. Migrant and Refugee Youth's Sexual and Reproductive Health and Rights: A Scoping Review to Inform Policies and Programs. Int J Public Health 2023; 68:1605801. [PMID: 37342678 PMCID: PMC10278890 DOI: 10.3389/ijph.2023.1605801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives: Migrants and refugee youth (MRY) in Western nations are less likely to participate in sexual reproductive health (SRH) services. Consequently, MRY are more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. A scoping review was conducted to examine MRY's understanding of and the implications for inclusive sexual and reproductive health and rights (SRHR) programs and policies. Methods: A systematic search of literature across seven academic databases was conducted. Data were extracted following Partners for Dignity and Rights' Human Rights Assessment framework and analysed using the thematic-synthesis method. Results: 38 literature (peer-reviewed, 24 and grey, 14) were considered eligible for inclusion. The findings highlighted significant barriers and the under-implementation of SRHR support and services by MRY. Key policy implications include a need for programs to support MRY's SRHR education, diversity, equity and inclusiveness and privacy protections. Conclusion: The review shows that the emerging evidence on MRY SRHR suggests gaps in practices for resourcing policies and programs that promote sustainable SRH for vulnerable populations. Policies for MRY's SRHR should prioritise programs that focus on diversity, equity and inclusion with targeted education and community resourcing strategies for sustainability.
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Affiliation(s)
- Michaels Aibangbee
- School of Health Science, Western Sydney University, Penrith, NSW, Australia
| | - Sowbhagya Micheal
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
| | | | | | - Rashmi Pithavadian
- School of Health Science, Western Sydney University, Penrith, NSW, Australia
| | - Zakia Hossain
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Elias Mpofu
- Translational Health Research Institute, Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
- Rehabilitation and Health Services, University of North Texas, Denton, TX, United States
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Tinashe Dune
- Translational Health Research Institute, Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, Australia
- Discipline of Psychological Sciences, Australian College of Applied Professions, Sydney, NSW, Australia
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4
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Greenbaum J, Kaplan D, Young J, Asnes AG, Gavril AR, Gilmartin ABH, Girardet RG, Heavilin ND, Laskey A, Messner SA, Mohr BA, Nienow SM, Rosado N, Forkey H, Keefe R, Keeshin B, Matjasko J, Edward H, Stedt E, Linton J, Gutierrez R, Caballero T, Falusi O“LO, Giri M, Griffin M, Ibrahim A, Mukerjee K, Shah S, Shapiro A, Young J. Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients. Pediatrics 2023; 151:190310. [PMID: 36827522 DOI: 10.1542/peds.2022-060416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Exploitation and labor and sex trafficking of children and adolescents is a major public health problem in the United States and throughout the world. Significant numbers of US and non-US-born children and adolescents (including unaccompanied immigrant minors) are affected by this growing concern and may experience a range of serious physical and mental health problems associated with human trafficking and exploitation (T/E). Despite these considerations, there is limited information available for health care providers regarding the nature and scope of T/E and how providers may help recognize and protect children and adolescents. Knowledge of risk factors, recruitment practices, possible indicators of T/E, and common medical, mental, and emotional health problems experienced by affected individuals will assist health care providers in recognizing vulnerable children and adolescents and responding appropriately. A trauma-informed, rights-based, culturally sensitive approach helps providers identify and treat patients who have experienced or are at risk for T/E. As health care providers, educators, and leaders in child advocacy and development, pediatricians play an important role in addressing the public health issues faced by children and adolescents who experience exploitation and trafficking. Working across disciplines with professionals in the community, health care providers can offer evidence-based medical screening, treatment, and holistic services to individuals who have experienced T/E and assist vulnerable patients and families in recognizing signs of T/E.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia
| | - Dana Kaplan
- Department of Pediatrics, Staten Island University Hospital, Northwell Health Physician Partners, Staten Island, New York.,The Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Janine Young
- Department of Pediatrics, University of California, San Diego, California
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Dando CJ, Ormerod TC, Atkinson-Sheppard S. Parental experiences of the impact of grooming and criminal exploitation of children for county lines drug trafficking. J Public Health (Oxf) 2022:6843552. [DOI: 10.1093/pubmed/fdac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/17/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
Abstract
Background
County lines is used to describe the illicit drug supply model whereby drugs are transported from one area of the country to another, often by children believed to have been physically and psychologically coerced to do so. County lines is a serious threat to public health, with significant negative impacts on the physical and psychological health and wellbeing of children and families.
Methods
We conducted in-depth interviews with parents of children involved in county lines to understand their experiences and the impact of grooming and recruitment. Interviews were conducted between December 2019 and January 2021. Thematic analysis identified four primary themes: (i) out of nowhere behaviour change, (ii) escalation and entrenchment, (iii) impact of intervention failures and (iv) destructive lifestyle choices.
Results
Parents from across England all reported similar experiences, and so these data offer novel insight into potential grooming and recruitment indicators. All were frustrated by the prevailing vulnerable narrative, which they argued hindered understanding. A lack of consultation, and reports of numerous intervention failures was common.
Conclusion
The importance of giving parents a voice and involving them as a potential first line of defence, and how the current vulnerability narrative appears to be closing impactful education opportunities are discussed.
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Affiliation(s)
- Coral J Dando
- University of Westminster Department of Psychology, , London W1W 6UW , UK
| | - Thomas C Ormerod
- University of Sussex School of psychology, , Falmer BN1 9PL , UK
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Ram S, Goldin D. Primary Care Clinician's Knowledge of Trafficking in Persons: A Systematic Review. J Transcult Nurs 2022; 33:388-397. [PMID: 35075928 DOI: 10.1177/10436596211070285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Human trafficking is an enormous global threat. Primary care clinicians are part of a safety net of professionals who may be able to identify and assist trafficking in persons (TIPs). The purpose of this systematic review was to explore clinicians' knowledge, attitudes, and behaviors in identifying and assisting TIPS in health care settings. METHODOLOGY The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. Searches were conducted using PubMed, Medline Plus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases that yielded 130 articles, of which 10 quantitative articles met eligibility criteria. Eligibility determination, data extraction, synthesis, and evaluation were independently conducted by the authors. RESULTS Findings revealed deficits in clinician's knowledge, attitudes, and behaviors on identifying TIPs in clinical settings. In addition, cultural influences affect TIP's decision-making. DISCUSSION To support the wide-ranging needs of TIPs, education programs that include clinician trainings on the skills required to identify and assist TIPs across cultures is warranted.
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Affiliation(s)
- Sharda Ram
- Florida International University in Miami, USA
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Kaltiso SO, Greenbaum VJ, Moran TP, Osborne AD, Korniotes J, Marazzi G, Clery M. Feasibility of a screening tool for sex trafficking in an adult emergency department. Acad Emerg Med 2021; 28:1399-1408. [PMID: 34133829 DOI: 10.1111/acem.14313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Human trafficking (HT) is a human rights violation and public health issue. People with a history of HT are likely to see a physician during their exploitation. A screening tool was developed and implemented in a busy urban emergency department (ED) to aid in the identification of this population. OBJECTIVE The objective was to retrospectively assess a HT screening tool implemented in an urban ED and evaluate the feasibility of the tool as a component of standard emergency care. METHODS This was a retrospective observational study conducted at an urban adult ED after the implementation of an original 11-item HT screening tool. Adult patients 18 years and older were screened based on high-risk chief complaints, "red flag" risk factors, or provider gestalt. All patients with a positive screen were offered the opportunity to speak to a social worker, who then determined the patients' likely trafficking status. Data analysis was performed on this group of patients. RESULTS A total of 26,974 patients were screened in the ED during 2019. Of these patients, 189 of them had a positive screen. A total of 37 patients were confirmed to have a likely sex trafficking status based on the federal definition. Eight of these patients elected to go to a community partner safe house. Positive responses to eight of the questions were significantly associated with likely sex trafficking status. Through regularized regression analysis, the predictive power of the screen was found to be derived from seven of the questions. CONCLUSION Through the implementation of this screening tool, providers in a busy urban ED were able to identify patients with an experience of sex trafficking and offer them resources using a trauma-informed approach. This study demonstrates the feasibility of implementation of screening in the ED and identifies seven of the questions used as predictive of likely sex trafficking.
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Affiliation(s)
- Sheri‐Ann O. Kaltiso
- Department of Emergency Medicine Emory University School of Medicine Atlanta Georgia USA
| | - V. Jordan Greenbaum
- Children’s Healthcare of Atlanta Atlanta Georgia USA
- International Centre for Missing and Exploited Children Alexandria Virginia USA
| | - Timothy P. Moran
- Department of Emergency Medicine Emory University School of Medicine Atlanta Georgia USA
| | - Anwar D. Osborne
- Department of Emergency Medicine Emory University School of Medicine Atlanta Georgia USA
| | - Jessica Korniotes
- Grady Emergency Care Center Grady Memorial Hospital Atlanta Georgia USA
| | - Grace Marazzi
- Grady Emergency Care Center Grady Memorial Hospital Atlanta Georgia USA
| | - Michael Clery
- Department of Emergency Medicine Emory University School of Medicine Atlanta Georgia USA
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Global Crises: Gendered Vulnerabilities of Structural Inequality, Environmental Performance, and Modern Slavery. HUMAN ARENAS 2021. [PMCID: PMC7937546 DOI: 10.1007/s42087-020-00154-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Climate change and modern slavery are two of the most significant human rights crises of our time. Women and children are disproportionately vulnerable to such crises, which are intensified under inequitable social conditions and driven by structural barriers to female equality. No research has yet looked at the complex relationship between climate crisis, structural gender inequality, human insecurity, and vulnerability to modern slavery. Our research examined the relationship between environmental stressors associated with climate change, selected structural inequalities, and the estimated prevalence of modern slavery cases across 180 countries. Regression analysis revealed significant results. These findings suggest that indicators of poor environmental health may exacerbate structural social inequalities and increase women’s risk of falling victim to modern slavery. Results showed that women’s share of seats in parliament, education for women, tree cover loss, agricultural management, and air quality assumed more substantial roles in this prediction. Awareness of the unique relationship between environmental indicators of climate change, gender inequality, and modern slavery provides a meaningful contribution to our understanding of factors driving human exploitation. Additionally, we propose a gender analysis of environmental stressors to address both the climate crisis and structural inequalities that increases female vulnerability to insecurity.
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Iglesias-Rios L, Harlow SD, Burgard SA, Kiss L, Zimmerman C. Gender differences in the association of living and working conditions and the mental health of trafficking survivors. Int J Public Health 2019; 64:1015-1024. [PMID: 31243470 PMCID: PMC10506657 DOI: 10.1007/s00038-019-01269-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/05/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To assess the association of living and working conditions experienced during trafficking with mental health of female and male survivors. METHODS We analyzed a cross-sectional study of 1015 survivors who received post-trafficking services in Cambodia, Thailand, and Vietnam. Modified Poisson regression models were conducted by gender to estimate prevalence ratios. RESULTS For females, the elevated prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms was associated with adverse living conditions, while for males the prevalence of anxiety (PR = 2.21; 95% CI 1.24-3.96) and depression (PR = 2.63; 95% CI 1.62-4.26) more than doubled and almost tripled for PTSD (PR = 2.93; 95% CI 1.65-5.19) after adjustment. For males in particular, excessive and extreme working hours per day were associated with more than a four- and threefold greater prevalence of PTSD. Being in a detention center or jail was associated with all three mental health outcomes in males. CONCLUSIONS Providers and stakeholders need to consider the complex mental health trauma of the differential effects of living and working conditions for female and male survivors during trafficking to support treatment and recovery.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Department of Epidemiology, Center for Midlife Science, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Siobán D Harlow
- Department of Epidemiology, Center for Midlife Science, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Sarah A Burgard
- Department of Sociology, College of Literature Science, and the Arts, University of Michigan, 500 S State St, Ann Arbor, MI, 48109, USA
| | - Ligia Kiss
- Department of Global Health and Development, Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Cathy Zimmerman
- Department of Global Health and Development, Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
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Patterns of violence and coercion with mental health among female and male trafficking survivors: a latent class analysis with mixture models. Epidemiol Psychiatr Sci 2019; 29:e38. [PMID: 31142398 PMCID: PMC7083520 DOI: 10.1017/s2045796019000295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS Human trafficking is a crime and a human rights violation that involves various and simultaneous traumatic events (sexual and physical violence, coercion). Yet, it is unknown how the patterning of violence and coercion affects the mental health of female and male trafficking survivors. METHODS We conducted a cross-sectional study using a sample of 1015 female and male survivors of trafficking who received post-trafficking assistance services in Cambodia, Thailand or Vietnam. We assessed symptoms of anxiety and depression with the Hopkins Symptoms Checklist and symptoms of post-traumatic stress disorder (PTSD) with the Harvard Trauma Questionnaire. Violence was measured with questions from the World Health Organization International Study on Women's Health. Latent class analysis (LCA) was used to identify distinct patterns of violence and coercion in females and males. Novel multi-step mixture modelling techniques were employed to assess the association of the emergent classes with anxiety, depression and PTSD in females and males. RESULTS LCA identified two distinct classes of violence and coercion experiences in females (class I: severe sexual and physical violence and coercion (20%); class II: sexual violence and coercion (80%)) and males (class I: severe physical violence and coercion (41%); class II: personal coercion (59%)). Females in class I had a two-fold increase in the odds of anxiety (OR = 2.10; 95% CI: 1.57-2.81) and PTSD (OR = 2.07; 95% CI: 1.03-4.17) compared with females in class II, but differences in the prevalence of anxiety, depression and PTSD were not significant when comparing males in class I to class II. CONCLUSIONS Specific patterns of violence and coercion provide a more in-depth understanding of the role of gender in the experience of violence and coercion and its association with mental health in survivors of trafficking. This information could be useful to target comprehensive mental health services for female and male trafficking survivors.
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