Introduction to Cultural Safety

When Indigenous women access health care services, they often experience and receive mistreatment by health care practitioners (Telus Talks, 2023). This could include experiences of racism, discrimination, negative stereotypes, and prejudice. For example, health care practitioners may resort to stereotypes such as Indigenous women are intoxicated, have been drinking, and/or are under the influence of substances when identifying the reason for seeking treatment (Telus Talks, 2023). Similarly, there is a common misconception of Indigenous women having a high pain tolerance and threshold (The Indian Residential School History and Dialogue Centre., 2022). This could have detrimental impacts of the overall health and livelihood of Indigenous women seeking care and treatment when experiencing pain, especially related to CVD/s.

The topic and conceptualization of cultural safety was first introduced by Irihapeti Ramsden, a Māori nurse scholar from Aotearoa (New Zealand.) The initial concept was first implemented to frame, and to provide a historical and sociocultural context, for the health disparities experienced by Māori people. Through ongoing promotion and advocacy, the concept of cultural safety has been taken up by health policy makers, educators and health professionals around the globe (Wilkinson, 2021).

In Canada, the implementation of cultural safety has been a slow progress in health care systems. In their Final Report – Calls to Action (2015) the Commissioners of the Truth and Reconciliation Commission of Canada called upon government [and educators] to address health care inequality and health related policies negatively impacting Indigenous people (Wilkinson, 2021). Following the report, efforts have been undertaken to create cultural safety programming and training for health care practitioners. Examples include:  the ‘Sanyas Cultural Safety Training Program’ and ‘Foundations of Indigenous Cultural Safety’ – Indigenous Primary Health Care Council.

The notion of cultural safety is based on the understanding that a disproportionate number of Indigenous people are experiencing chronic health conditions and health inequality that is related to the impact of colonialism and how it manifests in the healthcare system (Anderson-DeCoteau, 2016).  These experiences are often culturally unsafe and do not include Indigenous cultural perspectives to treatment (Wilkinson, 2021).

The following pages will address the issues of the power and privilege dynamic, racism, and discrimination as factors contributing to the culturally unsafe environment for Indigenous people.