 This study examined the governance of the aboriginal and Torres Strait Islander health worker, A. Antsau, role in a North Queensland health district. It found that racist structures and practices within the health system have created a climate of structural violence against A. Antsau HWS. This has resulted in a lack of recognition, support and embeddedness of their unique knowledge, skills and functions. To address these issues, the study recommends strengthening governance to support A. Antsau HWS through critical attention to the role of race and racism in regulatory structures, organizational practice and inter-professional relationships. This article was authored by Stephanie Top, Jocelyn Tully, Rachel Cummins and others.