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Astrophysics is a discipline that has a lot to do with environmental justice, even if it doesn’t look like so. Astrophysics research nowadays involves both large cutting-edge infrastructures and a great number of people and institutions, usually at international level. Most of these projects require to be placed in very specific environments, which are not very common on our planet, to function in the best conditions. The territories chosen to host large facilities for astrophysics, as remote as they can be, are not empty. In most cases, they are inhabited (or regularly frequented) by people who are not always involved in the decision process and may see the construction as an invasion of lands they have owned or occupied for centuries. In this context, we believe that what pulls people away from environmental justice advocacy, especially those who do not live in or near these territories, is the lack of information and awareness about this topic, which may cause strongly polarized opinions and harshful discussions on the topic. To try to fill this gap, as science communicators we decided to develop a game-based activity which fosters the debate about this connection. Among our inspirations is the struggle of the protectors of Mauna a Wākea, on the Big Island of Hawai‘i. The mountaintop is a sacred place for Native Hawaiians, who have been fighting to protect their ancestral land from the construction of the Thirty Meter Telescope (TMT). There are many other examples of large astronomical infrastructures and their impact on territories, including in our own country (Italy), some more virtuous than others, that show how the Astrophysics research world is strongly connected to environmental justice. For this activity, we chose the Creative Commons PlayDecide format, which aims to facilitate simple, respectful and fact-based group discussions. The game consists of a different set of cards containing facts about the topic, issues for different interest groups and personal stories of fictional individuals who are involved or affected by the topic. By telling the stories of different characters involved in this kind of situation, we aim to enlarge the debate, fostering the change of perspective of players. We wish that many people around the world download and use the game, either during public outreach activities with schools and the general public or as a self-awareness exercise within the astronomical community. The game does not refer to a specific facility, but we researched study cases related to astronomical observatories in sites such as Mauna a Wākea (Hawaiʻi), Kitt Peak and Mount Graham (Arizona), the Sardinia Radio Telescope in Italy as well as ongoing projects such as the SKA Observatory in South Africa and Australia. In particular, for the story cards, we strived to provide a balance in terms of gender and affected communities, trying as much as we could to avoid stereotypes, in the awareness that we, as the authors of the activity, are a group of white, female astronomers from a G7 country.

Toniolo, Rachele and Claudia Mignone. 2023. "Some students play the PlayDecide activity at a Science Festival in Italy." In 4S Paraconference X EiJ: Building a Global Record, curated by Misria Shaik Ali, Kim Fortun, Phillip Baum and Prerna Srigyan. Annual Meeting of the Society of Social Studies of Science. Honolulu, Hawai'i, Nov 8-11.

The authors are Paul E. Farmer, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. All of the authors are involved with the nonprofit organization Partners in Health in some capacity, with experience working with rural or poverty stricken areas. Paul E Farmer, the primary author of the article is a medical doctor also working for the United Nations who has published many other articles on similar topics.

The main argument is that susceptibility to certain diseases is not only determined by biology but also social conditions, leading to a disproportionate disease rate among the poor, and minority groups without access to medical services. The author shows that addressing these social conditions leads to a decrease in disease when combining treatment and prevention plans.

The argument is supported through a combination of historical information including rates of AIDS in the early 1990’s and a study done in Baltimore in an effort to reduce AIDS rates in African Americans, who were more likely to be in poverty, by addressing monetary barriers to heath care. Two more recent cases are also used to support the main argument, implementing a method created by the Partners in Health to prevent transmission and provide AIDS care in rural Haiti and rural Rwanda. Throughout the article references were made to the current medical professional’s dilemma, where they are in a position to see the social inequalities contributing to disease rates but not trained to report or change common social contributing factors. This makes the article more relatable to the reader that may have experience in the medical field which elps to support the argument.

“Pioneers of modern public health during the nineteenth century, such as Rudolph Virchow, understood that epidemic disease and dismal life expectancies were tightly linked to social conditions [55,56].” (Farmer 5)

“…large­-scale social forces—racism, gender inequality, poverty, political violence and war, and sometimes the very policies that address them—often determine who falls ill and who has access to care.” (Farmer 1)

“In an attempt to address these ethnic disparities in care, researchers and clinicians in Baltimore reported how racism and poverty— forms of structural violence, though they did not use these specific terms—were embodied [33,34] as excess mortality among African Americans without insurance.” (Farmer 2)

Data collected from a study done in Baltimore in the 1990’s, including statistics and observations is used to support the main argument. The methods used in Haiti and Rwanda as well as the results from implementing those methods are also used as examples for the claim that social conditions greatly impact disease susceptibility.

Emergency response is addressed in terms of both long term response and future emergency prevention. The method used by the PIH in both Haiti and Rwanda were implemented in response to high rates of disease in those places, showing that an emergency can occur gradually and the response may require creating a permanent system. Prevention is also discussed as a portion of emergency response, that it is important not only to deal with emergencies as they occur but also to identify the causes and change the system to prevent the same emergency in the future.

The article has primarily been referenced in later works by Paul E. Farmer who has written several other papers and articles on both the medical state of Haiti and Rwanda as well as structural violence in many capacities. The article was initially published in 2006 and has since been published in journals, books, as well as open online collections for use by the sts community.

The bibliography shows references to several papers by many of the same authors, showing it was produced as a continuation of previous ideas but showing new information learned through the PIH’s activities in Haiti and Rwanda. The bibliography also shows many references from the early to mid 1990’s showing similar thoughts to initial research done in Baltimore and other places with high rates of AIDS.

The article focused on treatment and prevention of diseases affecting communities, however I was interested in the initial causes of these epidemics in places that were originally free of disease. I read an article “The Tipping Point” published in the New York Times that explained multiple social theories as to how epidemics begin, using Baltimore as a case study.

I looked into the stated mission and some of the work done by the Partners in Health, as they are a group that responds to epidemics. It was interesting to see that they focus not on immediate emergency response but instead on creating lasting infrastructure to gradually stop epidemics, as well as educating locals on how to react to future emergencies of the same nature.

The article mentions that clinicians are not trained to see social issues as they are so commonplace in everyday life as to become invisible, I felt that was a limited mindset and read an article written by Doctors for America. The article showed that while it is true that comparatively little time is spent on social issues during a doctor’s education, clinicians dealing directly with patients clearly recognize social conditions effecting health. The article suggests that the lack of attention on those issues in the medical field is not due to ignorance but rather the lack of an existing system through which individual doctors can report their experiences and work towards a solution.