Push and pull factors

One-Sided Tug-of-War: The “Push” of Poverty and the “Pull” of Demand

Demand has recently gained more prominence in initiatives to end human trafficking, especially sex trafficking (19). However, demand is a key factor in all forms of human trafficking. Factors such as poverty, an abusive or neglectful home environment, or political instability in one’s country or region are considered “push” factors, in that they may compel people to enter situations with a high risk of human trafficking; whereas demand for slave labor is considered a “pull” factor, in that it is demand that creates a market in which human traffickers operate and profit (9). There is no “push” without “pull”. “Pull” factors exploit those in poverty because the “push” factors of meeting basic human needs of food and shelter for oneself and/or one’s family are compelling. The more “push” factors that one experiences, the stronger the effect of the “pull” factor of demand.

When someone is trafficked, this also perpetuates the same preexisting “push” factors. Trafficked people commonly remain at the same level of economic disadvantage, with the added strain of being enslaved through force, fraud, and/or coercion. Therefore, if human trafficking survivors are freed, they are often in a financial situation that is very similar to the situation that served as a “push” factor to begin with. They may lack marketable job skills, employment opportunities, and access to resources such as consistent food or housing. In some cases, they may have the added strain of stigma or a criminal record from trafficking (e.g., in the case of prostitution). Survivors will also almost invariably have the added strain of the biological and psychological sequelae of being trafficked. These consequences of trafficking have been noted as risks for reentering a trafficking situation (20). Thus, stopping the cycle of trafficking requires addressing both “push” and “pull” factors, including poverty and risk for ongoing poverty (https://www.cancerincytes.org/push-and-pull-the-intersections-of-pove#:~:text=Factors%20such%20as%20poverty%2C%20an,factor%2C%20in%20that%20it%20is )

Natural Disasters

The COVID-19 pandemic is putting the world under enormous strain, affecting the lives of everyone. The unprecedented measures adopted to flatten the infection curve include enforced quarantine, curfews and lockdowns, travel restrictions, and limitations on economic activities and public life. While at first sight, these enforcement measures and increased police presence at the borders and on the streets seem to dissuade crime, they may also drive it further underground. In trafficking in persons, criminals are adjusting their business models to the ‘new normal’ created by the pandemic, especially through the abuse of modern communications technologies. At the same time, COVID-19 impacts the capacity of state authorities and non-governmental organizations to provide essential services to the victims of this crime. Most importantly, the pandemic has exacerbated and brought to the forefront the systemic and deeply entrenched economic and societal inequalities that are among the root causes of human trafficking (https://www.unodc.org/documents/Advocacy-Section/HTMSS_Thematic_Brief_on_COVID-19.pdf )


Homelessness greatly increases risks and vulnerablilities for human trafficking. Traffickers exploit basic needs, such as for food and shelter as well as other vulnerabilities like a dependecy on drugs , to lure people into labor or sex trafficking.

LGBTQ+ youth disproportionately experience homelessness. Many LGBTQ+ youth experience discrimination and marginalization because of their identity. Family members or caregivers may reject, neglect, or abuse them increasing their vulnerability to homelessness and exploitation. In 2017 nearly 30% of LGBTQI youth were kicked out of their homes into the streets by caregivers.

Drugs and Substance Dependence

Drugs play a unique and complex role in human trafficking. Drug use or a drug dependency can increase a person's vulnerability to being trafficked. Traffickers may use them to coerce or force a victim into submission or compliance. Drugs may also be used as a means to cope with mental and physical trauma developed from the experience of being trafficked.

Due to the role of drugs in human trafficking, providers serving people with a substance dependence should utilize training and screening tools to enhance their ability to identify human trafficking survivors.

Mental Health

Mental Health issues can increase vulnerability to human trafficking. Traffickers may identify and take advantage of individuals experiencing mental illness. People with a major mental illness such as schizophrenia are more likely to be physically victimized than those who do not have any mental illness (Stoklosa, MacGibbon, & Stoklosa, 2017).

The experiences of human trafficking can cause new mental health issues to develop as well as exacerbate previously existing issues. Anxiety, depression, self-harm, suicidal ideation, post-traumatic stress disorder, and psychosis have all been found among survivors of labor and sex trafficking.

Clinicians may be frequently coming in contact with patients experiencing human trafficking, therefore providing an oportunitity for intervention. Increased training and use of verified screening tools can increase the chances of clinicians identifying human trafficking victims.


Systemic racism and racist stereotypes increase the vulnerability of people of color particulary the black community. Since the time of African slavery in the United States, race has always been part of the development of the labor trafficking and commercial sex industies. Not only does systemic racism increase the possibility of experiencing human trafficking, it also affects the identification and treatment of human trafficking survivors.


Male youth expericencing human trafficking may be at a higher risk of being infected with HIV which can develop into AIDS. HIV attacks the immune system, though it can be treated it remains within the body for life, there is no cure. Infection occurs via bodily fluids. Victims of human trafficking may experince sexual violence, rape, or may not be allowed to use protection during sex. These circumstances increase the posibility of being infected with HIV as well as other sexually transmitted infections. Many victims of human trafficking also experience substance dependency which can also increase risk as needles may not be sterile.



Altun, S., Abas, M., Zimmerman, C., Howard, L. M., & Oram, S. (2017). Mental health and human trafficking: responding to survivors' needs. BJPsych international, 14(1), 21– 23. https://doi.org/10.1192/s205647400000163x

Butler, C. N. (2015). The Racial Roots of Human Trafficking. UCLA Law Review, 62, 1464- 1514.

Stoklosa, H., MacGibbon, M., & Stoklosa, J. (2017). Human Trafficking, Mental Illness, and Addiction: Avoiding Diagnostic Overshadowing. AMA Journal of Ethics, 19(1), 23-34. doi:10.1001/journalofethics.2017.19.1.ecas3-1701