Aboriginal and Torres Strait Islander people continue to experience cumulative harms across health systems, including inequities in cancer diagnosis, treatment access and completion of care. While policies emphasise cultural safety and reform, racism is rarely measured as a system level determinant of health outcomes and without measurement, accountability remains limited. My current research examines whether racism in cancer care can be operationalised as a measurable exposure within existing health data systems. Using data from the Aboriginal and Torres Strait Islander owned and led Kulay Kalingka study, Australia's first national Indigenous-led cancer cohort study, I have analysed associations between reported experiences of racism in healthcare and cancer treatment completion. This work applies epidemiological methods to assess whether racism functions as a quantifiable predictor of treatment outcomes.

Rather than designing a new surveillance system, this project establishes the empirical and methodological foundation that would make one possible. It evaluates the validity of racism measures, examines data governance considerations and explores how such measures could be integrated into routine reporting structures. Building systems that support healing requires more than policy intent; it requires measurable indicators, transparent reporting and defined responsibility for action. By demonstrating that racism can be measured rigorously and linked to clinical outcomes, this work contributes to a future model of surveillance in which health systems are accountable not only for service delivery, but for the structural conditions shaping patient experiences.