Government of Canada actions to address anti-Indigenous racism in health systems

On this page

• Overview
• Joyce’s Principle
• Federal Response
• Anti-Indigenous racism reporting
• Contact us
• Available resources and services
• Other reports

Overview

The impacts of colonialism and systemic racism, including anti-Indigenous racism, continue to harm Indigenous people in accessing healthcare.

Eliminating racism experienced by First Nations, Inuit and Métis Peoples in Canada’s health systems is essential to deliver equitable access to high-quality, culturally safe care to close the gaps in health outcomes.

Canada is taking concrete action, by creating meaningful partnerships with Indigenous Peoples, to advance health systems that are equitable and grounded in respect for all.

This commitment requires addressing systemic barriers to healthcare access, embedding anti-racism and anti-oppression principles into policy and practice, and supporting Indigenous-led approaches that uphold respect, and self-determination in health care institutions.

Joyce’s Principle

On September 28 2020, Joyce Echaquan sought treatment at a medical centre in Joliette, Quebec. Shortly after she recorded a Facebook Live video showing the racist treatment she received, Joyce died without getting the medical care she needed. The 2021 final report produced from the coroner’s inquest into Joyce Echaquan’s death stated that racism and prejudice from hospital staff contributed to her death.

In direct response to the death of Joyce Echaquan, the Government of Canada convened 4 national dialogues between October 2020 and January 2023 to listen to lived experiences and identify measures to address anti-Indigenous racism in Canada’s health systems. During these dialogues, Indigenous communities, Indigenous health professional organizations, clinical providers and Indigenous leaders shared powerful accounts of racism and systemic discrimination present within the health system.

In Joyce’s memory, the Atikamekw Nation created Joyce’s Principle, which aims to guarantee that all Indigenous people have the right of equitable access to all social and health services as well as the best possible physical, mental, emotional and spiritual health care without any discrimination.

With the government’s support, the Manawan Atikamekw Council representing Joyce’s Nation, created the Joyce’s Principle Office, which began operating in July 2023. The office focuses on promoting Joyce’s Principle through its adoption by various bodies, including governments and professional associations. The mission of the office is to inform both Indigenous and non-Indigenous people about Joyce's Principle, ensuring its integration into the practices, policies, and delivery of health and social services across Canada.

Federal response

In response to the national dialogues, Budget 2021 investments supported the creation of the Addressing Anti-Indigenous Racism in Canada’s Health Systems (AAIR) initiative. The AAIR initiative responds to the Missing and Murdered Indigenous Women, Girls and 2SLGBTQI+ people (MMIWG) Calls for Justice, and the United Nations Declaration on the Rights of Indigenous Peoples Action Plan by implementing Joyce’s Principle and fostering culturally safe health systems free from racism and discrimination, where Indigenous Peoples are respected and safe.

You can learn more about the National Dialogues here.

Funding is provided to Indigenous communities and organizations across all distinctions, including urban settings, with a focus on improving services for Indigenous women, 2SLGBTQI+ people, people with disabilities, and others who may face intersecting forms of discrimination. By investing in First Nations, Inuit, and Métis-led, community-driven projects, the AAIR initiative upholds Indigenous Peoples’ right to self-determination and works to close gaps in access to equitable, culturally safe and relevant health services.

Find out more about the federal funding here.

Anti-Indigenous racism reporting

Racism remains widespread in Canada’s health care system and continues to undermine the safety and wellbeing of Indigenous patients. Many Indigenous people report feeling unsafe in health care settings, with the hospital emergency room being the most commonly reported setting:

• 50% of First Nations people living in urban centers
• 34% of Inuit
• 36% of Métis

Among Métis people, 46% reported feeling the doctor’s office as the most uncomfortable setting^{Footnote 1}.

Based on a study conducted in British Columbia in 2020, more than 1 in 5 Indigenous patients reported feeling a complete lack of safety when accessing mental health and substance use services, social work, security or discharge planning services^{Footnote 2}.

In 2024, 55 of 66 studies reported Indigenous patients felt that they were not treated well by health care providers. One in 5 Indigenous people reported experiencing racism or discrimination within the health care system1.Indigenous-specific racism in healthcare is most often covert, manifesting as being ignored, subjected to clinical neglect, having symptoms dismissed, or being stereotyped by providers^{Footnote 3}.

Indigenous health care workers also face pervasive racism in the workplace. Fifty-two percent of Indigenous health care workers based in British Columbia reported experiencing racism due to their Indigenous identity. Nearly all reported moderate to severe negative impacts on their mental and emotional health, as well as career limitations^{Footnote 2}.

Within health care settings, racism is significantly underreported. Studies suggest that most Indigenous patients believe reporting racism would not change behaviour and many have seen where previous complaints fail to result in meaningful action.

Contact Us:

If you have any questions or would like to learn more about this, you can send an email to: AntiIndigenousracism-AntiRacismeAutochtone@sac-isc.gc.ca

Available resources and services

• Addressing Anti-Indigenous racism resources for health professionals
  • Find reports, tools and strategies needed to learn, educate, recognize and address anti-Indigenous racism within healthcare.
• Projects addressing anti-Indigenous racism in health systems
  • Find Indigenous-led projects funded through the AAIR initiative, such as the establishment of the first ever First Nations Health Ombudsperson's Office by the Federation of Sovereign Indigenous Nations.
• Get involved with anti-Indigenous racism experts
  • Become involved by volunteering or contacting a health authority for more information.
• Become an Ally
  • Explore our partners' Rise Above Racism campaign today and do your part to help end anti-Indigenous racism in Canadian health systems.
• Addressing Racism and Discrimination in Canada’s Health Systems Program
  • Health Canada funding for projects that address systemic racism and discrimination in Canada's health systems.
• Joyce's Principle
  • Created by the Atikamekw Nation in honour of Joyce Echaquan

Other reports

• Implementing the United Nations Declaration on the Rights of Indigenous Peoples Act
  • This act provides a roadmap for the government to work together with First Nations, Inuit and Métis, to implement the United Nations declaration.
• Truth and Reconciliation Commission's Calls to Action: Health
  • How the Government of Canada is responding to the Truth and Reconciliation Commission's Calls to Action 18 to 24.
• Federal Anti-Racism Secretariat
  • The Government of Canada's work to combat systemic racism and racial discrimination.
• Missing and murdered Indigenous women, girls and 2SLGBTQI+ people
  • Working with organizations across the country to end violence against Indigenous women, girls and 2SLGBTQI+ people.