Unveiling Child Trafficking Patterns

Preeti Panda, MD, a pediatric emergency medicine fellow at Stanford, conducts research to shed light on the socio-economic characteristics of trafficking victims, paving the way for informed policy initiatives in emergency departments.

Panda is leveraging large data systems to address child trafficking.

Panda first learned about the problem of child trafficking when serving as an AmeriCorps volunteer in a small town in upstate New York where several youth were at risk for exploitation. “I realized if it was happening there, it was happening everywhere,” she says.

Stanford Hospital is in close proximity to both San Francisco and Santa Clara counties, which are among the FBI’s list of top child sex trafficking areas in the nation, and individuals who are trafficked often experience abuse or health problems that cause them to present multiple times to local emergency departments (EDs).

Panda, a pediatric emergency medicine fellow, often screens pediatric ED patients for signs of trafficking risk factors such as if they’ve run away from home, live in a group home or foster care, have been incarcerated, or have a history of abuse. Other signs include physical marks like tattoos intended as branding, injuries that don’t make sense, or an ambiguous caregiver or friend in the examination room.

Through multiple studies, Panda is developing a more detailed portrait of pediatric victims of trafficking to better enable ED physicians to identify those at risk.

Impact of COVID-19 on Pediatric Trafficking

Panda used the World Health Organization’s International Classification of Diseases codes that distinguish victims of forced labor or sexual exploitation, paired with data from more than 49 hospitals around the country pulled from the Pediatric Health Information System to conduct an interrupted time series analysis. She identified approximately a twofold increase in trafficked youth presenting to pediatric EDs in the early months of the COVID-19 pandemic. Quantifying this phenomenon will help EDs better prepare when the next pandemic strikes.

Socio-economic Characteristics of Trafficked Children

Panda utilized the Child Opportunity Index (COI) coupled with ED utilization to better characterize trafficked children. The COI takes into account 28 factors that can influence a child’s opportunities, including average income, nearest grocery store, access to health care, and other variables. A low score indicates low socio-economic status. Panda found that while most trafficked children had low COI scores, close to one-third were from high, or very high socio-economic backgrounds. Looking ahead, Panda will also use the data to identify disparities in care provided to trafficked and non-trafficked care children.

Panda’s research is funded in part by a grant from the Society for Academic Emergency Medicine. As part of her grant, Panda was able to create an advisory board of survivors of human trafficking to help guide her research and reporting. She is working with this advisory board to create policy briefs from this work to better inform future initiatives in the ED setting.