Healthcare Advocacy Against Youth Displacement and Labor

Jay Tamirisa¹, Lynda Warner, MS²

Displacement and child labor are intricately linked, affecting millions of children and young adults under the age of 25 years. 

The number of youth and young adults experiencing homelessness is estimated to be around 1.5 per 1,000 individuals per the U.S. Department of Housing and Urban Development (HUD) Office of Community Planning and Development’s “Point-In-Time Count” (PIT) statistics, with a 15% increase between 2022 and 2023. A national household survey – “Voices of Youth Count,” revealed that one in 30 youth from 13-17 years experienced homelessness over 12-months. Teens separated from their homes due to natural disasters, poverty, addiction, abuse, or due to conflict often find themselves at a heightened risk of being forced into child labor. This relationship is underpinned by a vicious cycle of continued poverty, economic instability, and decreased access to health-focused resources. 

Displaced youth may feel compelled to enter the workforce to support themselves at the expense of their education. According to the U.S. Department of Labor, the number of minors under the age of 18 years employed in violation of child labor laws increased by 283% between 2015 and 2022. Displaced teens and unaccompanied children crossing borders are vulnerable to exploitative labor practices. According to the International Labor Organization (ILO), around 160 million children are engaged in child labor, with a significant proportion of them coming from impoverished families. Africa ranks the highest in the absolute number of children (92 million) in child labor trafficking, followed by Asia (49 million). On a global scale, refugee minors from conflict zones often end up working in agriculture (70%) and factory work or domestic servitude to survive. Per the same report from ILO, children aged 5 to 11 years (nearly 50%) constitute the largest share of those in child labor working in hazardous conditions. 

The Problem of Inequities:

Displacement and child labor disproportionately affect racial and ethnic underrepresented youth due to systemic racism rooted in history, community disinvestment with poverty and lack of access to healthcare, and underlying economic inequities.  Youth displacement is more pronounced among racial and ethnic underrepresented groups in the U.S., with 11% of American Indian and Alaskan Natives, 7% of Black individuals, and 7% of Hispanic individuals relative to 4% of White individuals in one year. Moreover, the National Institute of Justice reports that child labor trafficking remains a hidden phenomenon that mostly affects economically and socially vulnerable youth in the US – 58% of the youth are immigrants when compared to 42% who are American citizens. Both male (38%) and female (60%) child labor trafficking victims were identified with an average age of 14 years.

Overall Impact:

Mental and Physical Health

The consequences of displacement and child labor include the effects of trauma (history of abuse or exploitation, for example) leading to Post Traumatic Stress Disorder (PTSD), feelings of low self-esteem and isolation due to disrupted social support system and marginalization, and anxiety of readjustment and acculturation. The National Child Traumatic Stress Network and studies report that displaced youth often struggle with forming healthy relationships and achieving emotional stability later on in life due to the unaddressed trauma. Coupled with the demands of labor-intensive jobs, the displaced youth face physical exhaustion, poor living conditions, and inadequate nutrition further leaving them vulnerable to illnesses. Prolonged exposure to stress and unsafe conditions often leads to chronic health issues among displaced youth. Overcrowded, unsanitary living spaces expose them to indoor air pollution, while poor regulations in labor settings increase their risk for respiratory diseases like bronchitis, asthma, and chronic obstructive pulmonary disease. Labor-intensive jobs with suboptimal ergonomics and heavy lifting further heighten their vulnerability to musculoskeletal disorders such as arthritis and chronic back pain. Limited access to healthcare worsens these risks, perpetuating the long-term cycle of health challenges into adulthood.

Academic and Career Implications

Displacement and child labor disrupt educational trajectories, as teens are forced to prioritize work over school. Frequent relocations, inadequate socio-ecological resources, and emotional and physical exhaustion impede their ability to perform well academically. The National Center for Homeless Education in the U.S. reports that displaced youth have lower high school and college graduation rates compared to their peers. The lack of a solid educational foundation confines them to low-paying, unstable jobs, perpetuating economic instability and reducing their capacity to contribute meaningfully to society. Child labor undermines individual potential and impedes national economic growth with the poorly educated and unstable workforce.

A Complex Socio-Ecological Problem

Displacement spans structural, relational, and individual levels, transcending monocausal explanations. It often emerges as a complex interplay between macro-level factors such as societal or economic issues like unemployment, natural disasters, or unaffordable housing. Micro-level etiologies include personal or relational conflicts like abuse, neglect, violence, or substance abuse. Structural conditions such as siloed systems that shuffle youth through “child welfare” or stigmatize them within local communities without transportation or placement services compound the problem. Relational conditions like rejection or discrimination despite living in a “place” due to chronic parental or familial fights, sexual or physical abuse, or neglect further exacerbate displacement. On an individual level, factors such as addiction, mental illness, or a preference for autonomy without viable support systems can also drive youth into displacement.  The lack of supportive structures and the need for survival often force displaced youth into exploitative circumstances, including child labor, as they navigate their precarity.

Advocacy and Solutions – Healthcare Advocacy and Community Engagement: 

As Healthcare Systems:

• Facilitate preventive care programs including addiction support, family counseling, and safe-parenting workshops.
• Train healthcare professionals to recognize and address signs of displacement, neglect, and abuse.
• Provide trauma-informed care.
• Establish collaborative and continued mental health services (with social workers and child-protective services) for displaced youth and those forced to do child labor.
• Ensure mobile clinics and telehealth options reach under-represented areas and populations.
• Advocate for integrated care models that combine healthcare with housing, school/education, and social services, focusing on need-based resource allocation.

As Students at Schools and Youth in Communities:

• Promote peer mentorship and support programs in schools and in community events. 
• Advocate for school-based services like counseling centers and food security initiatives.
• Organize community-wide education campaigns to destigmatize issues like homelessness, mental health, family instability, and the issue of child labor in person or using social media and school clubs.
• Partner with organizations – fundraisers or donation drives for displaced youth. Students can volunteer their time at safe houses.
• Start practical initiatives to help with transportation, affordable housing, recreational facilities, and job training for displaced youth.
• Youth can advocate for policy change for stronger child labor laws by starting petitions and working at state and national levels.
• Youth can be instrumental in collecting zip code-based or community-based demographics/data assessing the burden of displacement and child labor.

As Policy Makers:

• Enact housing-first policies that provide a stable shelter before requiring additional conditions.
• Reform child welfare systems to avoid siloed services with long-term support systems.

• Implement stricter laws to prevent child exploitation and provide protections for at-risk youth.
• Work with communities and customize solutions to the cultural and socio-ecological infrastructure, to close the gaps across racial and ethnic groups.

Conclusion:

Addressing these intertwined issues requires multifaceted approaches, including policy reform, community engagement, and robust healthcare advocacy. Policy reforms must tackle systemic barriers by integrating comprehensive social support systems, ensuring affordable housing, and implementing protective laws to prevent exploitative child labor. Community engagement must focus on creating safe spaces and integrated support networks that promote inclusion and belonging. Healthcare advocacy plays a pivotal role by ensuring access to mental health services, trauma-informed care, and addiction support while training healthcare professionals to identify and address the unique needs of displaced youth. Together, these strategies can help build a safety net that addresses the pervasive problem of displaced youth and child labor.

¹ Sophomore, Carroll ISD, Southlake, Texas

² Organizational Psychologist, Private Consultant, Southlake, Texas