Position Brief - Human Trafficking-Implications for 21st Century School Nurses

Human Trafficking - Implications for 21st Century School Nurses

Position Brief

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It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) be knowledgeable about the scope of human trafficking. In particular, school nurses should be able to recognize signs that a child may have been exposed to a trafficker, may be in the process of being groomed into trafficking, or may already be a victim of trafficking and be prepared to respond within a trauma-informed framework. Prevention, early recognition, and support of children/youth who are victims or suspected victims of human trafficking are critical to their present and future physical/emotional well-being.


The federal law defines human sex trafficking as the 

“recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act, in which a commercial sex act is induced by force, fraud, or coercion, or in which the person forced to perform such an act is under the age of 18 years" (Trafficking Awareness Training for Health Care Act 2014).

Human trafficking is a major global health and human rights problem, affecting predominantly women and girls, but also men and boys.  In the United States, human trafficking has been identified in cities, suburbs, and rural areas in all 50 states (Grace et al., 2014).  Studies generally indicate that the age range of entrance into sex trafficking and commercial exploitation is approximately 12 to 16 years (Greenbaum, Crawford-Jakubiak, & American Association of Pediatrics [AAP] Committee on Child Abuse and Neglect, 2015). Labor trafficking, another form of human trafficking,  can take many forms which include debt bondage where a child incurs a debt he or she is never able to pay off or where a child is forced to work in someone’s home for long hours with little or no pay (National Center on Safe Supportive Learning Environments, 2017).  

Schools are just one of the many venues traffickers use to recruit children, controlling them through physical, psychological, or emotional means. Human trafficking, whether sex trafficking or labor trafficking, is a form of modern-day slavery. Human trafficking robs human beings of their freedom and their dignity (U.S. Department of Homeland Security, 2017). It destroys families, knows no boundaries, and is a federal crime (Trafficking Awareness Training for Health Care Act 2014). School nurses and other school staff are well positioned to help with identification and intervention for this mostly hidden crime.

Schools strive to create a safety net for students by building healthy environments, ensuring student safety, promoting health, and assuring readiness to learn (Lewallen, Hunt, Potts-Datema, Zaza, & Giles, 2015).  School nurses are an integral part of the school team, partnering with law enforcement and community health agencies, to recognize and respond to suspected human trafficking. School nurses use their assessment skills to provide pro-active surveillance that is critical to help identify risks associated with human trafficking. 

In addition, school nurses serve as health experts on the school teams and can increase staff awareness, educate staff on indicators and the nature of trafficking crimes, increase parent and student awareness of the risks and realities of trafficking, and assist in the development of district or school-wide protocols for identifying a suspected victim or responding to a disclosure from a suspected victim.

School nurses have the opportunity to interact with children daily. Understanding how human trafficking intersects on school grounds is imperative to prevent another child from becoming a victim.


Grace, A., Lippert, S., Collins, K., Pineda, N., Tolani, A., Walker, R.,... Horwitz, S. (2014). Educating healthcare professionals on human trafficking. Pediatric Emergency Care, 30(12), 856–861. doi: 10.1097/PEC.0000000000000287

Greenbaum, J., Crawford-Jakubiak, J.E., & AAP Committee on Child Abuse and Neglect. (2015). Child sex trafficking and commercial sexual exploitation: Health care needs of victims. Pediatrics,135(3), 1-9. doi: 10.1542/peds.2014-4138

Lewallen, T.C., Hunt, H., Potts-Datema, W., Zaza, S., & Giles, W. (2015).  The whole school, whole community, whole child model: A new approach for improving educational attainment and healthy development for students. Journal of School Health, 85(11), 729-739. doi:10.1111/josh.12310

National Center on Safe Supportive Learning Environments. (2017). Human trafficking in America’s schools.  Retrieved from http://safesupportivelearning.ed.gov/human-trafficking-americas-schools 

Trafficking Awareness Training for Health Care Act 2014. H.R.5411 — 113th Congress (2013-2014). Retrieved from https://www.congress.gov/bill/113th-congress/house-bill/5411

Acknowledgment of Authors:

Linda Neumann, RN

Patrice Lambert, MSN, RN, SNC

Brenda Lindahl, RN

Elizabeth McDermott, BSN, RN, NCSN

Susan Morgan, MEd, RN, NCSN

Lisa Kern, MSN, RN, NCSN

Adopted: February 2018

Renewed: April 2019

Suggested citation: National Association of School Nurses. (2018). Human trafficking: Implications for 21st century school nurse (Position Brief). Silver Spring, MD: Author.

All position briefs from the National Association of School Nurses will automatically expire 18 months after publication unless renewed and recommended for position statement or other NASN document development.