A robust public health system that strengthens equitable population health must eradicate Indigenous-specific racism and advance true reconciliation. Nearly 10 years since the release of Truth & Reconciliation Report, Canadian institutions – including public health systems – have yet to advance the Calls to Action in accountable and sustained ways. The result is that Indigenous-specific racism remains entrenched as a systems-level challenge in public health systems.
In her True Reconciliation framework, BC First Nations matriarch Puglaas Jody Wilson-Raybould emphasizes that the onus of reconciliation responsibility is not on Indigenous people, but on settler individuals and systems: “we need you to fix yourselves.” As public health systems (PHS) are strengthened following COVID-19, our proposed research asks, what do we need more of, and what do we need less of to ‘fix ourselves’ and fulfill our reconciliation obligations as a public health system? The True Reconciliation framework outlines 3 core practices – learn, understand, act – that inform our research objectives:
O1-LEARN: We propose to initiate a longitudinal cohort study involving PHS workforce in BC to determine the ‘status quo’ engagement with reconciliation obligations, and assess feasibility of a novel U&U Action of Reconciliation Obligations Self-Assessment tool for scale up beyond BC.
O2-UNDERSTAND: Next, we will engage with key informants to characterize reconciliation “bright spots” in a series of case studies.
O3-ACT: Finally, we will weave together evidence from O1&2 to co-create a ‘Fix Ourselves’ Framework to inform systemslevel integration of reconciliation obligations in PHS.
We will shed light on systems-level solutions that build the expertise and capacity of the PHS to eradicate Indigenous-specific racism and advance reconciliation across PHS Building Blocks (BBs). Proposed research focuses primarily on capacity of leadership (BB6) and workforce (BB4) to implement evidence-informed (BB2) reconciliation across all system activities (BBs 1-6). It will generate evidence to support the new NCCPH Core Competency 9.3 focused on Indigenous rights and reconciliation. It responds directly to health system priorities and instructions provided by Indigenous Peoples, using pragmatic mixed methods.
The Unlearning & Undoing White Supremacy & Indigenous Specific Racism Lab for Population & Public Health (U&U Lab) is a novel research collaboration of First Nations, Métis, and settler health scholars and leaders embedded within BC’s PHS. The U&U Lab aims to advance rights and health of Indigenous Peoples by building evidence to eradicate Indigenous-specific racism, settler colonialism, and white supremacy within PHS. A major strength of the proposed research is involvement of senior Indigenous and settler PHS leaders from the First Nations Health Authority, the BC Centre for Disease Control, and the BC Office of the Provincial Health Officer. We have commitments from PHAC and the National Collaborating Centre on Determinants of Health to collaborate on knowledge mobilization.
We are well positioned to lead system transformation. The project will inform and catalyze collaborative Indigenous-spcific anti-racist transformation throughout BC’s PHS, as well as public health systems across Canada and settler states globally. It will support evidence-based action in other jurisdictions, moving towards true reconciliation with the First Nations rights and title holders, and other First Nations, Inuit, and Métis Peoples living on these territories.