Health inequalities and health equity challenges for victims of modern slavery

Dando, C.J., Brierly, R., Saunders, K. and Mackenzie, J.-M. 2018. Health inequalities and health equity challenges for victims of modern slavery. Journal of Public Health. Advanced online publication. doi:10.1093/pubmed/fdy187

TitleHealth inequalities and health equity challenges for victims of modern slavery
TypeJournal article
AuthorsDando, C.J., Brierly, R., Saunders, K. and Mackenzie, J.-M.
Abstract

Background
Modern slavery is a serious organized crime, with severe consequences for the physical and mental health of victims, and so has public health implications. Anecdotally many victims of sex slavery experience difficulties accessing healthcare. Public Health England recently articulated the importance of health engagement to address modern slavery but little is known about the experiences of the survivors.

Methods
We conducted in depth interviews with Albanian female survivors of sex slavery who all displayed significant and complex health needs. Interviews were conducted between July 2017 and January 2018. Thematic analysis identified four primary themes: (i) barriers to access, (ii) negotiating access, (iii) health needs and care received and (iv) overall experience of primary care.

Results
Survivors experienced repeated challenges accessing healthcare, for themselves and their children, and initially could not access GP services. When accompanied by an advocate they reported qualitatively and quantitatively improved experiences resulting in improved permeability. Confusion surrounding eligibility criteria and a lack of understanding of modern slavery emerged as the primary barriers, fueling biased adjudications.

Conclusions
The importance of advocates, enabling rights-based approaches, improving understanding about access to health services for vulnerable groups, and a need for education across health service settings are discussed.

Keywordshealth services, primary care
JournalJournal of Public Health
ISSN1741-3842
Year2018
PublisherOxford University Press
Digital Object Identifier (DOI)doi:10.1093/pubmed/fdy187
Web address (URL)https://academic.oup.com/jpubhealth/advance-article-abstract/doi/10.1093/pubmed/fdy187/5155322
Publication dates
Published online02 Nov 2018

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