Acknowledging colonialism in the room: Barriers to culturally safe care for Indigenous Peoples
Bibliographic record
Abstract
Indigenous peoples worldwide continue to face health inequities compared to non-Indigenous populations. Frameworks like cultural safety can be used to mitigate these inequities; however, this is not widely implemented in healthcare settings. Thus, additional research into barriers to providing culturally safe care are critical. To address this need, we examined the existing barriers to culturally safe care for Indigenous peoples in Canada, and Māori in Aotearoa New Zealand, through the perspectives of key informants. Major issues identified by key informants included systemic racism, lack of organisational accountability and/or buy-in, ineffective health-provider education, funding, health system structure, undervaluing Indigenous knowledge, negative framing, terminology, and changes to the concept of cultural safety over time. When examined closely, systemic racism and ongoing settler colonialism are the key driving forces underpinning many of the barriers identified. Findings from this research point to barriers at every level and require a system-wide, intersectoral approach in order to provide culturally safe care for Indigenous peoples and advance Indigenous health equity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".