The know-do gap of settler colonialism: Janet Smylie,  Ricci Harris,  Sarah-Jane Paine,  Irma A Velásquez,  Nimatuj,  Raymond Lovett, ‘Beyond shame, sorrow, and apologies—action to address indigenous health inequities’, BMJ, 2022, 378


Abstract: On 1 April 2022, Pope Francis made a historic apology to indigenous peoples in Canada for what he described as “deplorable” abuses occurring in church run residential schools.1 This statement is one of multiple apologies recently offered by world leaders for colonial injustices and abuses of indigenous people. For many, these apologies represent landmark events. However, as indigenous health scientists who bear witness to the real life impacts of colonisation on indigenous health today, we cannot help but raise the question: “How do these apologies get translated into tangible changes that reduce indigenous/non-indigenous health inequities?” While we do not presume to hold all the answers, we are certain of two things. Firstly, while indigenous leadership and direction is essential, the hard work of change needs to be shared by all who have benefitted from colonisation. Secondly, current inaction appears to be rooted in so called know-do gaps—meaning there are gaps between what we know and what we do in policy and practice. In this instance, clear policy directions come from indigenous leadership globally and a growing evidence base that could inform action, yet indigenous/non-indigenous health inequities persist, and in many cases are getting worse. Building on these premises, we have three cross-cutting recommendations for non-indigenous decision makers, administrators, and practitioners of health and social system policy, on how to translate white and/or settler privilege into tangible change.

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