We know First Nations people encounter frequent and pervasive racism in every facet of their daily lives. But since the 2023 Voice referendum, these experiences have increased significantly – including in health care.

When First Nations people face racism at the doctor’s office or in a hospital or pharmacy, it can profoundly impact both their mental and physical health.

Evidence shows it can lead to significant health disparities. First Nations people are less likely than other Australians to get screened for a medical condition, or receive a diagnosis, follow-up care or treatment. As a result of past negative experiences, they may delay or avoid seeking care altogether.

In our research with First Nations people in New South Wales, we’ve gathered more than 400 accounts of being in hospital. Participants described both the racism they experienced, and what made them feel culturally safe.

We found the single biggest factor was having access to an Aboriginal hospital liaison officer to help them navigate the system while in hospital.

Here’s why that works, and what else First Nations people need.

First, what is cultural safety?

This concept originated in Aotearoa New Zealand in the late 1980s, when Māori nurses identified the need to counter institutional racism and cultural bias encountered by both Māori patients and clinicians in the mainstream health system.

Cultural safety means creating an environment where people are safe and their identity, culture and experience are recognised and respected.

In health care, this can look like a clinician taking the time to build rapport and trust with a patient, involving them in decisions, making the physical environment more........

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