Prevalence of High-Risk Social Determinants of Health Among Patients Experiencing Human Trafficking Compared With the General Health System Population

The Atrium Health Human Trafficking Advocacy Team (HT-EMAT) is a hospital-based response team that mitigates the harm imposed by trafficking. Strategies include matching patients to mental health treatment or residential restorative programs, and treating the medical comorbidities of trafficking. In 2024, hospital sites began screening for four key social determinants of health (SDOH). The primary objective of this study was to compare the prevalence of high risk SDOH needs between the trafficking population in the general patient population. The secondary objective was to identify the number of confirmed trafficking victims with high-risk social needs.

This retrospective analysis identified confirmed cases of human trafficking from the HT-EMAT database between January 1, 2024 and November 1, 2025. SDOH results for confirmed cases were retrieved from the medical record, while results for housing, food insecurity, transportation, and utilities for the general patient population were sourced using enterprise PowerBI data. Proportions were used to quantify SDOH needs among patients experiencing HT. The odds ratio of high-risk SDOH factors between the HT population and the broader patient group was compared using a chi-square test.

A total of 147 confirmed patients experiencing HT were identified in the HT-EMAT database with a positive evidence-based screen. Of these, 92 were minors and 55 were adults. Among minors, 28 (30%) received SDOH screening, while 35 adults (64%) were screened. Among adults, the prevalence of unmet needs for housing, food insecurity, and transportation was significantly higher in the HT population compared to the general hospital population (all p < 0.0001), while utility needs did not differ significantly (p = 0.08). For minors, only unmet housing needs were significantly elevated in the HT group (p = 0.001); other SDOH categories showed no significant differences (all p > 0.1).

Housing was the main high risk SDOH for both adults and minors experiencing trafficking. Adults demonstrated high unmet needs for food insecurity, and transportation. Additional research is needed to understand the relationship between SDOH needs and trafficking, and to develop SDOH mitigation strategies that lower the risk of exploitation.