Tackling Stigma Champion #3

We speak with Kate Dunn, a nurse, educator, and advocate from Mississaugi First Nation, Canada, about the systemic barriers that keep Indigenous people from care. From creating culturally grounded healthcare resources to teaching the next generation of nurses to be comfortable with being uncomfortable, Kate shares how community-led, heart-first approaches can shift the narrative.

In our third Tackling Stigma Champion Interview, Kate highlights how most Indigenous people she speaks with cannot recall a positive healthcare experience, showing just how deep stigma runs. She shares her vision for change — from embedding reciprocity and peer navigators into care, to creating brave spaces where the next generation of practitioners can drive change.

Kate’s tips at a glance

Create brave spaces, not just safe spaces: Nurses (and other clinicians) must get comfortable with being uncomfortable
Ask, don’t assume: It’s okay to say, “ I think I’m missing something – help me understand”
Fund peer navigators: Extra hands focused on connection can transform patient experiences
Honour reciprocity: Food, gifts, and incentives can be cultural, not bribes
Fund relationship roles: Every project should dedicate time and people to building trust
Value community-led approaches: Communities know what they need – funders must trust that
See the human, not the label: Every interaction is a chance to restore dignity
Engage where people are: Join community events, integrate into other health programs
Use creative tools: Stickers and pocket booklets carry messages further than typical methods
Collaborate: Find allies in your workplace, in your sector, in your community and work together

Tell us a bit about yourself and your current work

I’m from Mississaugi First Nation and I’ve been a nurse for a long time. After practicing in the US, I grew frustrated with the business model of healthcare – it felt like you weren’t allowed to care anymore. When I moved back to Canada, licensing barriers meant I couldn’t practice for four years.

So, during that time, I worked on a hepatitis C pathway project bridging funders, government, and a First Nation. It quickly found it was impossible to please everyone and stay true to the community. The experience pushed me to reconnect to my Indigenous worldview – my family, language, and sense of responsibility. Elders have told me I carry “double the responsibility” because I must advocate for both sides: as an Indigenous woman but also as a nurse.

When public health officials asked why people weren’t lining up for hepatitis C treatment, community leaders said: “There’s nothing connecting us at a heart level.” That led me to work with elders and knowledge keepers to create culturally connected resources. We co-created a 23-minute film on liver wellness that focused on hope and healing, not blame. It became a PhD project and opened doors to advocate in many spaces.

Now I’m assistant professor in Indigenous context and innovations on wellbeing at York University School of Nursing and I also lead the Indigenous Circle for Liver Wellness Solutions in Ontario. For me, wellness isn’t just about medicine – it must include land, identity, and culture.

What are some examples of stigma you’ve witnessed?

I think stigma has different layers. There’s self-stigma, but that comes from structures that make you feel that way about yourself. There are also different experiences of stigma that are connected to culture, and others that aren’t.

We can’t just say, ‘Here’s the fix for stigma,’ because it plays out through so many different nuances, contexts, and lived experiences. But it is always there.

For example, I’m currently conducting interviews as part of a project, and I ask Indigenous people to share a positive healthcare experience. I’ll say, “was there a time you felt like a human in a healthcare interaction?” Almost no one can answer yes. Almost no one has a positive story. Our system is so broken.

What needs to shift — in people or in the system?

Peer workers and case navigators should be in every healthcare and clinical setting. They may not be the ones doing the charting or running the code, but their sole role would be to connect — to make sure the patient is having a human experience, feeling heard and understood. Creating and funding space for that kind of role could transform care. Whether structures are willing to support it is another question, but I can almost guarantee it would change the experience of a lot of people.

A misunderstanding around incentives also needs to change, particularly with indigenous communities. Some people see incentives or honoraria as bribery, but in Indigenous cultures they’re a sign of reciprocity. You’re sharing this with me, I’m sharing that with you. Projects should build in food, gifting, and reciprocity for time from the start. If you tack them on at the end, it feels tokenistic.

The same goes for relationship-building. Every project should dedicate time and budget for nurturing trust. For example, when we showed the liver wellness film in community, we paired it with a meal and time to talk together afterwards. In settings like that you might normally see one or two people step forward for hepatitis C screening — but with the film, the meal, and the discussion, 95% of attendees engaged in screening. It wasn’t just head knowledge, it was heart knowledge, and that’s what motivated engagement. .

It’s so important to remember that just because a project is cultural and relational, it doesn’t mean it’s not clinical. We can braid those together.

Do you see positive change coming?

I do – especially with younger generations. I tell my nursing students: you are the changemakers.

Many older nurses, nurse practitioners, and doctors were trained in a different worldview — a different time where the attitude was, “I’m here because I know best and I can fix this.” That doesn’t work anymore. It’s up to the new generation of practitioners to step into these spaces and say, ‘This doesn’t feel right. This isn’t okay.’

They’re the ones who have to raise the flag and raise awareness. My advice is to start now: step into those brave spaces, find like-minded co-workers, build alliances, and work together to drive change.

How do you challenge stigma in real time?

I teach a social justice in healthcare class as part of the nursing degree, where I challenge students to stop sugarcoating and face the injustices that make people sick.

Unless you backtrack to that point and get comfortable with being uncomfortable, there are no safe spaces. And you can’t make things culturally safe. It’s more about asking: how do we create brave spaces where we can talk, process, and learn to advocate for the other voices in the room?

Humility is also important. Shut up and listen. If you don’t understand something, it’s okay to say, “I’m missing something here – help me understand.” Asking questions opens the door to real collaboration.

What creative ways do you tackle stigma in your settings?

The film was a direct creative response focused on culture, story, land, and hope. It gives people that heart connection or understanding that encourages hepatitis C screening and shows how this awareness can help foster an awareness of the importance of the liver and a healthier, and better connected community around wellness.

It’s about listening and understanding what will work for each community. Outside of the film, we’ve also created a pocket-sized booklet decorated with clan animals, and framed as a myths and facts around hepatitis C. Kids love stickers, so we designed salamanders and axolotls, and several other animals that regenerate, to link liver regeneration with healing.

Another of my favourite initiatives was teaming up with a HIV awareness day, bringing hepatitis C screening into that space. At first people might whisper about who’s lining up, but by the end of the day it becomes normal to get engage in screening. I could feel the stigma melt away in real time.

The point is to find what’s cool or familiar in community and adapt it to share relational and hopefilled messages. These messages spread through families and schools, normalising conversations and breaking down stigma over time.

We need brave spaces, not just safe spaces: Kate Dunn on stigma in Indigenous healthcare