Diagnosis: Human Trafficking

There is a new team member in first responders identifying human trafficking victims in the United States: the health sector. The World Health Organization established the International Classification of Diseases (ICD) to standardize medical records. The ICD Tenth Revision, Clinical Modification is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care. Earlier this year, the American Health Association’s (AHA) Hospitals Against Violence initiative urged the development of ICD codes for classifying human trafficking in partnership with Massachusetts General Hospital’s Human Trafficking Initiative and Freedom Clinic and Catholic Health Initiatives.

Starting in October 2018, healthcare providers can use 29 human trafficking-related diagnosis codes in their records that differentiate trafficking from other types of abuse. The codes address both confirmed and suspected adult and child sex / labor exploitation as well as maltreatment and neglect. This will help track the number of victims and provide appropriate treatment. More importantly, these codes represent a new method of data collection for the identification of victims. 

According to the AHA fact sheet, data tracking of confirmed and suspected trafficking cases will serve two purposes: enabling the health care system to better track victim needs and a viable source of data collection to inform public policy to develop an infrastructure of services and resources.

According to 2016 research in the Journal of Human Trafficking, thirteen U.S. states now have laws that address education about human trafficking, while seven specifically require mandatory reporting of minors who are victims of trafficking. The findings are instructive to not only practicing physicians and other professionals, who are now mandated reporters of trafficking victims in some states, but also to regulatory and legislative bodies contemplating enacting such laws in an effort to address trafficking.

This is wonderful news, but just like any other diagnosis, correctly applying the new medical codes means appropriate and standardized professional training in indicators of human trafficking. The far-reaching impact could well be that human trafficking indicators become a global, standardized part of medical certification.

“Every nurse takes vitals. Some collect evidence.”

The health care sector is joining the ranks of first responders in a cohesive way that links learning to practice, law to medicine, and patients to community. The Emergency Nurses Association and the International Association of Forensic Nurses recently published a robust joint position statement that addresses opportunities and challenges of human trafficking such as screening, patient advocacy, trauma-awareness intervention, and partnership with law enforcement and child protective services. Forensic nursing is defined as the application of the nursing process to public or legal proceedings, and the application of forensic health care in the scientific investigation of trauma and/or death related to abuse, violence, criminal activity, liability, and accidents.  For victims, surviving violence from traffickers does not end at the hospital – it is the beginning of a long journey back to mental, physical and spiritual health. It is no coincidence that four of the six letters in health are ‘heal.’ – Ed Northstrum