Denialism: repudiation of anti-Indigenous racism in healthcare in Canada

Historically, healthcare in Canada has functioned as a tool of colonialism negatively impacting Indigenous peoples, producing endured health inequities and continues to shape contemporary health pathways for Indigenous patients, families and communities. Indigenous patients' healthcare experiences are shaped by encounters with anti-Indigenous racism, which directly affect both the quality of care they receive and their overall well-being. Anti-Indigenous racism in healthcare is sustained by denialism. Denialism is process through which anti-Indigenous racism is minimized, rationalized, or acknowledged without meaningful action, allowing colonial harms and inequities to persist. Using a framework that examines the intersection between denialism and anti-Indigenous racism across systemic, interpersonal, and societal levels, this perspective article analyzes how denialism translates recognition of inequity into inaction, stereotypes, and bias; thereby sustaining anti-Indigenous racism in healthcare settings. Addressing denialism is essential to dismantling structural racism in healthcare and to advancing meaningful, accountable change for Indigenous peoples in Canada.