Abstract
There is growing recognition that human trafficking is a health and public health issue, with severe health consequences affecting some of the most vulnerable members of society. Short- and long-term health harms are caused by the conditions of human trafficking and the way people are controlled for labor and/or sex. The United States health care system provides opportunities for interaction and engagement with patients throughout the entire lifespan—from pregnancy, to childhood, through adulthood; from acute emergency care, to long-term, and chronic care; from public health community outreach to hospitalizations. Primary care providers and organizations that expand access to care for medically underserved and vulnerable populations play a central role in caring for these patients across their lifespans. Examples of these safety net clinics include federally qualified health centers (FQHC), Indian Health Service clinics, free clinics, and others. There are a number of specific types of FQHCs including community health centers that focus on migrant and seasonal farmworkers, individuals experiencing homelessness, and residents of public housing. This chapter will focus on the variety of FQHCs collectively known as “community health centers.” As a significant part of the primary care system in the USA, community health centers are uniquely positioned to be the first point of contact with the health care system for many at risk for and affected by human trafficking. Community health centers provide many preventive services, health education programs, and community outreach, and therefore, have a greater reach into the populations at risk and affected by human trafficking. Furthermore, as a community oriented generalist system, community health centers have multiple opportunities to intercede and identify the issue amongst their patients. Secondary, tertiary, or quaternary care often relies on referrals from either primary care or other systems. In comparison, the community health center primary care system acts on the front line, engaging with patients who have been trafficked, at their first point of contact with the healthcare system.
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