From Commitment to Practice: Advancing Indigenous Data Sovereignty in Health Systems

Health systems across Canada are increasingly committing to support First Nations, Inuit, and Métis data sovereignty and Indigenous-led data governance frameworks. However, many organizations struggle to translate these commitments into practice. Uncertainty regarding Indigenous data governance, combined with concerns about misusing Indigenous data or violating emerging sovereignty principles, has produced a "freezing effect," where Indigenous data are collected but under-analyzed, under-reported, or avoided altogether. This hesitation can perpetuate the invisibility of anti-Indigenous racism and inequities in care. This article provides a brief overview of Indigenous data sovereignty and its grounding in Indigenous rights frameworks, including the United Nations Declaration on the Rights of Indigenous Peoples. Drawing on the experience of Providence Health Care in British Columbia, the article describes how Indigenous-led governance structures, data stewardship, and improvements in Indigenous self-identification processes can enable the ethical use of Indigenous health data to monitor inequities and inform quality improvement in health systems.