Taking a Stand to Remedy the Inadequacies of Action on Health Equity Exposed by COVID-19.

As we struggle with the impacts of a global pandemic, there is growing evidence of the inequitable impacts of this crisis. In this commentary, we argue that actions on health equity to date have been insufficient despite significant scholarship to guide both practice and policy. To move from talk to action on health equity, we propose the following five approaches: (1) reversing the erosion of publicly funded health systems; (2) creating broad economic means to support health; (3) moving health action upstream; (4) challenging ageist and/or ableist discourses; and (5) decolonizing approaches and enacting solidarity. Engaging in these actions will help close the gaps and address disparities made more evident during this global pandemic. The COVID-19 pandemic reinforces the need for us to move from discussion to action if we are to achieve health for all. Adopting a health equity lens is a means of both understanding and stimulating action to readdress the root causes of inequities and work toward a fairer, more just society.

Riting" cultural safety within the postcolonial and postnational feminist project: toward new epistemologies of healing.

The concept of cultural safety, developed by indigenous nurses in the postcolonial climate of New Zealand, has not been widely examined in North America. In this article we explicate the theoretical and methodological issues that came to the forefront in our attempts to use this concept in our research with different populations in Canada. We argue that this concept prompts us to "think critically" about ourselves and our patients, and to be mindful of our own sociocultural, economic, and historical location. This critical reflection has implications for how we live, relate to one another, and practice in our various professional disciplines. On the basis of our findings, we discuss how the concept might be rewritten within a critical postcolonial and postnational feminist discourse.

Healthcare restructuring with a view to equity and efficiency: reflections on unintended consequences.

This paper is developed from a research study that examined the hospitalization and helpseeking experiences of diverse ethnocultural populations in the era of healthcare restraint. Interview data were gathered from 60 patients while hospitalized and after their discharge home. Fifty-six healthcare professionals, the majority of whom were nurses caring for these patients while they were in hospital, were also interviewed. The data gathered in this study provides evidence to illustrate how restructuring associated with fiscal restraint designed to enhance efficiencies while ensuring the provision of medically necessary services, has had unintended consequences for some groups of patients and for nurses. These consequences have created a context for inequities in care delivery for those most vulnerable. In this paper we trace the ways in which the changed context of care delivery has exerted its effects on both nurses and patients and illustrate how each has sought to bridge gaps created when organizational supports are lacking. Our study data offer insight into the complexities of the practice setting and difficulties that arise when resources cannot be mobilized to match patients' needs. Our analysis examines how tensions between ideologies of efficiency and accessibility are navigated at the front lines, and draws attention to unintended consequences of the current policy context.

A post-colonial analysis of healthcare discourses addressing aboriginal women.

Annette Browne and Vicki Smye use post-colonial theoretical perspectives to inform a critical analysis of healthcare discourses related to cervical cancer among Canadian aboriginal women. They also examine how decontextualised discourses addressing aboriginal women's risks for cervical cancer can perpetuate negative stereotypical images of aboriginal women while downplaying or ignoring the historical, social and economic context of women's health risks.

'Cultural safety' and the analysis of health policy affecting aboriginal people.

Vicki Smye and Annette Browne explore the exportability of the concept of 'cultural safety' from the healthcare literature in New Zealand to inform an analysis of mental health policy discourse affecting aboriginal communities in British Columbia, Canada. The moral issues raised are, they suggest, ones that nurses in research, policy and practice must attend to when providing health care to marginalised, disenfranchised populations.

Rethinking cultural safety while waiting to do fieldwork: methodological implications for nursing research.

The concept of culture has been widely applied as an explanatory concept within health care, often within a framework representing culture as a fixed, reified entity, with cultural groups existing in a binary sense vis-;-vis mainstream culture. However, if our scholarship is to generate knowledge that addresses longstanding patterns of inclusion and exclusion along lines such as race, ethnicity, class, and gender, interpretive frames are needed that account for culture as embedded in fields of power relations; as mediated by social forces such as economics, politics, and historical patterns of oppression and colonization; and as being constantly renegotiated. In this article we trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalization and help-seeking experiences of diverse ethnocultural populations.