Indigenous-Specific Anti-Racism as the Foundation for Indigenous Cultural Safety in Health Systems

Indigenous-specific racism in the health system perpetuates significant harm for First Nations, Inuit, and Métis Peoples despite extensive system-wide commitments to Indigenous Cultural Safety. This article argues that Indigenous-Specific Anti-Racism must be foregrounded as a foundational approach to achieve Indigenous Cultural Safety. Indigenous Cultural Safety was developed to address conditions that make care unsafe for Indigenous Peoples; however, limitations in its implementation restricts its ability to confront settler colonialism, institutional power, and produce structural change. These limitations include its reduction to culturally responsive approaches, siloed cultural safety training that operates independently of organizational culture, and a focus on patient-provider interactions rather than systems-wide transformation. Indigenous-Specific Anti-Racism is a structural, action-oriented approach grounded in Indigenous thought leadership, inherent Indigenous rights, and relational accountability, focused on dismantling racist settler colonial structures. This discussion highlights the requirement of explicitly naming racism, locating institutional responsibility, and embedding anti-racism in decision-making.