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Towards untying colonial knots in Canadian health systems: A net metaphor for settler-colonialism

"Forceful imposition of settler-colonial laws and institutions violates Indigenous rights to self-determination, with profound impacts on health and wellness.” (p. 228)

The authors of this article use the metaphor of a large net to illustrate the depth and reach of settler colonialism in Indigenous Peoples’ lives. The net metaphor is based on a public art installation in Vancouver created by artist Janet Echelman. People can either see the net clearly (if you are Indigenous) or see very little or not at all (if you are not Indigenous). 

The authors describe the large structures of settler colonialism (e.g., the Indian Act and residential school system) as the wires that hold the net. The innumerable small wires that create the middle part of the net represent the everyday settler-colonial policies and practices that negatively impact the lives of Indigenous Peoples. The holes in the net symbolize the places where Indigenous Peoples have actively resisted, over centuries, the imposition of this violent system of oppression.

There is widespread evidence that structures of settler colonialism, White supremacy and anti-Indigenous racism lead to inequitable health outcomes between Indigenous Peoples and non-Indigenous peoples.

The authors note that it is the professional responsibility of settler health leaders to dismantle anti-Indigenous racism. They point out that legal responsibilities to uphold the inherent rights of Indigenous Peoples are identified in Canada’s Constitution and numerous laws, including British Columbia’s Declaration Act Action Plan and Canada’s adoption of the United Nations Declaration on the Rights of Indigenous Peoples. The work to dismantle anti-Indigenous racism entails a continuous and tenacious “untying [of] colonial knots”. It requires challenging and changing systems that are routinely built on settler values, approaches, and ways of thinking. Settler health leaders’ work should build on Indigenous Peoples’ resistance and advocacy for the recognition of their inherent rights. 

As a first step to untie colonial knots, settler health leaders and settler health organizations should work to understand their own relationship to settler colonialism, the unearned advantage they experience, and their own complicity in this system of oppression.

Questions that settler health leaders can ask of themselves include:

  • How am I either supporting or weakening foundational obligations made to First Nations, Inuit and Metis people?
  • How can I build space and accountability within my organization and community so that this work happens? 


Use this resource to:

  • Facilitate discussion and learning about settler health leaders’ (and others’) responsibility to uphold the inherent rights of Indigenous Peoples in public health and health care systems
  • Guide action on ways to create space and accountability for work that upholds the inherent rights of Indigenous Peoples in public health and health care systems


Alignment with NCCDH work:

Understanding ways in which public health can address anti-Indigenous racism and uphold the inherent rights of Indigenous Peoples aligns with other NCCDH work to address systemic racism and disrupt White supremacy.

In 2018, the NCCDH published Let’s Talk: Racism and health equity along with Key public health resources for anti-racism action: A curated list.

In 2020, the NCCDH published Let’s Talk: Whiteness and health equity.

In 2022, the Canadian Institutes of Health Research – Institute of Population and Public Health and the NCCDH co-hosted a virtual workshop, Future Search: Action for Disrupting White Supremacy and Racism in Public Health Systems. This workshop was the result of over a year of organizational collaboration and a joint desire to envision actively anti-racist public health systems and identify concrete actions for disrupting White supremacy.

In 2022, authors from the NCCDH, National Collaborating Centre for Methods and Tools, and Dalla Lana School of Public Health, University of Toronto, co-authored a review, “Structural interventions that affect racial inequities and their impact on population health outcomes: A systematic review.”


See other resources on anti-racism and health equity.


Jongbloed, K., Hendry, J., Behn Smith, D., & Gallagher Kwunuhmen, J. (2023). Towards untying colonial knots in Canadian health systems: A net metaphor for settler-colonialism. Healthcare Management Forum, 36(4), 228–234.

Tags: Indigenous health, Racism/racialization, White supremacy/Whiteness, Academic Institution, Government, Document, Journal Article