Written by: Julia Kocis
Human trafficking brings in an estimated global revenue of $150 billion a year. It is one of the fastest-growing transnational crimes due to its high-profit, low-risk equation. Traffickers exploit vulnerable populations, with women and children comprising 75% of its victims according to the United Nations Office on Drug and Crime. Risk factors, such as poverty, unemployment, homelessness, and abuse, increase the likelihood of an individual becoming a victim of trafficking and help to facilitate the practice, while protective factors such as education, and social support networks can help mitigate members of vulnerable populations from becoming part of this modern-day slave trade. A 2013 Health and Human Rights report noted that health consequences for the victims can include infectious diseases including sexually transmitted infections, mental health disorders such as anxiety, panic, and major depression, partly due to victim exposure to abuse, exploitation, and violence. To address the social needs of this population and the negative health outcomes experienced, it is important to first understand who and where they are.
The U.S. is listed as one of the top three countries for trafficking victims; the other top two countries listed were Mexico and the Philippines. However, a 2017 report from the International Labour Organization listed the U.S. region as only 4% representative of the total 4.8 million sex trafficking victims who were globally identified (see figure 1), and others have found that 60% of the 50,000 women and children estimated to be trafficked to the United States are from Southeast Asia, which would make it the largest regional source in the world for trafficking to the United States  . While these reports may seem to have a confusing and conflicting representation of trafficked persons across global regions, the fact remains that these numbers are large in comparison to what has been identified on a local level.
The most readily available dataset in the United States for individuals and groups studying human trafficking comes from the National Human Trafficking Hotline (NHTH) managed by Polaris. It allows callers to leave anonymous tips on trafficking activity as well as a recourse for victims to request help. The NHTH had 246,267 contacts from 2007 through 2019 and identified a total of 56,504 cases of human trafficking. These contacts represented 199,163 phone calls to the hotline, 16,899 online reports to the NHTH website, and 13,954 emails. Through these contacts with the NHTH, over 60,000 victims have been identified. It represents an inexhaustive sample of what the trafficking population is in the nation, but it serves as a starting point.
Local Data. Outside of the NHTH dataset, we have scant opportunity to analyze other statewide or local datasets; therefore, much of the local information is pulled from the NHTH sample. The Nationalities Service Center, an immigrant and refugee organization of Philadelphia, provided a subset of the PA data from the larger NHTH dataset from 2007 through 2016 and reported a total of 3,052 calls to the hotline resulting in 688 cases, 73% of which were for sex trafficking. The top venues for reported cases in Pennsylvania were:
- Commercial Brothels (119)
- Online (36)
- Hotel Based (31)
- Residential Brothels (22)
- Domestic Servitude (13)
- Restaurants (12)
- Health & Beauty (4)
Other data from the Commonwealth is emerging from the Administrative Office of the Pennsylvania Courts. It is extracted from the Common Pleas Case Management System and reflects the number of human trafficking cases that were filed and disposed as convictions. Out of the 159 cases filed between 2014 and 2018, 76% of those charged with trafficking offenses were males between the age of 30 to 39-years-old. Philadelphia County had the highest case count filed while Lehigh County ranked among the lowest case counts filed.
In 2014, Pennsylvania enacted their anti-trafficking statute titled Act 105 to provide prosecutors and law enforcement the ability to hold traffickers accountable for their crimes; prior to this, human trafficking cases in Pennsylvania were investigated and prosecuted solely at the federal level, which may help to explain why some of the local numbers are relatively low. Act 105 defines 13 elements to establish the crime of involuntary servitude. These range from providing victims with controlled substances, to abuse, or withholding property as a method of coercing them into performing commercial sex. It also allows prosecutors to seize and forfeit property and money from the traffickers that were used in perpetrating their crimes and includes a civil remedy for victims to sue their traffickers or anyone who profited from trafficking, and a provision for victims who have been charged with prostitution to have their convictions vacated.
According to a report by The Institute to Address Commercial Sexual Exploitation, as of 2016, there were 1,670 charges filed against prostituted persons for the crime of prostitution, of which eight of them were minors.
While the laws were enabled to help charge the trafficker and find legal remedies for its victims, the perception of what a true victim of this crime is remains elusive. The compiling of local data through the courts will take time as prosecution of these cases is extremely resource intensive. But if we lack a nuanced understanding of who the true victims are, victims go unserved, traffickers continue to operate with impunity, and we lose potentially valuable data that could help with future investigations, prosecution, and prevention. However, identification of the victims must take a multi-sector approach so that they are identified before they even reach the criminal justice system and provided the supports needed to transition back into the wider community.
Understanding the social determinates of health and life conditions that increase the risk of this type of victimization should be more fully examined to help identify potential victims at the onset in an effort to prevent victimization from occurring. In an AMA Journal of Ethics 2017 policy forum, it was stressed that public health methodologies provide an invaluable resource for this type of prevention because healthcare professionals understand that these victims are part of a spectrum of interrelated violence and systemic inequities all tied to the social determinants of health. Within the Lehigh Valley, cross-sector partners are beginning to envision a community-wide approach that will build a safety net of services as victim identification and data tracking improves.
 Perry McGregor, Kelsey, and Lindsay McEwing. “How do social determinants affect human trafficking in Southeast Asia, and what can we do about it? A systematic review.” Health and Human Rights Journal, Dec 2013. https://www.hhrjournal.org/2013/12/how-do-social-determinants-affect-human-trafficking-in-southeast-asia-and-what-can-we-do-about-it-a-systematic-review/
 U.S. Department of State. “Trafficking in Persons Report.” Jun 2019. https://www.state.gov/wp-content/uploads/2019/06/2019-Trafficking-in-Persons-Report.pdf
 International Labour Office. “Global Estimates of Modern Slavery: Forced Labour and Forced Marriage.” 2017. https://www.ilo.org/wcmsp5/groups/public/—dgreports/—dcomm/documents/publication/wcms_575479.pdf
5 “Prevalence of Human Trafficking in Pennsylvania.” Nationalities Service Center. Nd. https://nscphila.org/publications/prevalence-human-trafficking-pennsylvania
6 Villanova University Charles Widger School of Law, The Institute to Address Commercial Sexual Exploitation. “Report on Commercial Sexual Exploitation in Pennsylvania.” Spring 2017. https://cseinstitute.org/wp-content/uploads/2016/12/CSE-Report-Spring-2017.pdf
7 Rollins, Rochelle, et al. “Who is in Your Waiting Room? Health Care Professionals as Culturally Responsive and Trauma-Informed First Responders to Human Trafficking.” American Medical Association Journal of Ethics, vol.19, no.1:1-131, Jan 2017. pp. 63-68. https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-06/joe-1701.pdf