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Over half of the neighborhoods in Santa Ana (shown in pink on the map below), California are designated disadvantaged communities (DACs) by CalEnviroScreen, the leading tool for assessing environmental injustice in California. GREEN-MPNA, a community-based organization in Santa Ana, is working to change this through its DAC-X campaign: an action-oriented movement to reduce disadvantage through pollution reduction, health equity, economic justice, and inclusive governance. Aware of the risks of gentrification, the goal is to x-out disadvantage in a way that empowers rather than displaces current communities. The University of California EcoGovLab has worked closely with GREEN-MPNA on the design and development of the DAC-X campaign. The four pillars of the campaign were chosen, in part, because they align with the State of California’s own criteria for designating communities as disadvantaged. DAC-X’s design also draws together a diverse array of advocacy organizations, government agencies and schools working against issues that contribute to disadvantage, knitting together threads of work that often run in parallel. The long term goal is to increase these organizations’ collective capacity to address disadvantage – in a way that recognizes the intersectionalities and cross-scale interactions that produce it. One tactic we have used to advance the DAC-X campaign is the staging of Environmental Justice Stakeholder Meetings that bring relevant governmental agencies together in one room to speak and respond to Santa Ana residents.Thus far, these meetings have focused on pollution reduction and inclusive governance. Going forward, we will continue to grow our network of alliances in Santa Ana by organizing Environmental Justice Stakeholder Meetings to address other pillars of the DAC-X campaign, bringing for example, health equity advocates to the table, or educational institutions that could support workforce development. The DAC-X campaign itself – and this poster – also results from an alliance – between EcoGovLab (Browne, Adams, Fortun) and GREEN-MPNA (Flores, Gutierrez & Rea).

Browne, Aiden, James Adam, Jose Rea and Kim Fortun. 2023. "GREEN-MPNA's DAC-X Campaign for Environmental Justice: Designing for Alliance." 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 central argument is that healthcare professionals are not trained well enough in mentally/ emotionally handling patient relationships when providing end-of-life care for terminal/ chronic illnesses.

The narrative is sustained through Atul Gawande's experience and research into improving his end-of-life care for his own patients by meeting with other healthcare professionals (oncologists, palliative care experts and surgeons), and analyzing his actions with his father. The film has strong emotional appeal, as loss of loved ones is a common experience, and difficult for all parties involved. 

Scientific info isn't really in depth (disease processes aren't talked about) mostly just psycho-social aspects discussed. 

The stakeholders are Dr. Atul Gawande, other healthcare professionals, and the patients with terminal illnesses. They have to decide what the patient's priorities are, treatment options, and basically how much time and quality of life patients are willing to trade for extended years to live. Is the treatment making the patient worse or better? Doctors have to put themselves in a position of vulnerability by personally getting to know their patients, and deal with the guilt and blame if their treatments aren't successful or what they had said to the patient's family.

Emergency responders not portrayed in the film; only medical professionals involved in long-term patient care are addressed. 

Emergency responders are not portrayed in this film. This film focuses on long term care and the ethics of dealing with death, hospice, and gravely ill patients.

In this film, three groups of stakeholders are portrayed; doctors, patients, and mortality. The doctors depicted fight a loosing battle against aging, death, and terminal illness like cancer. They need to come to terms with the fact that they can't save everyone and they need to honor their patients wishes for how they want to conduct the end of their lives. The patients need to accept their impending death with the assistance of their doctors and advocate for how they want to conduct the end of their lives. And mortality is an object which is immaterial but ever present, and both doctors and patients need to learn how to grasp with it.

The narrative is sustained through emotional stories of end of life care from both the physician and patient perspectives performed by both Dr. Atul Gawande and by other healthcare professionals such as oncologists, palliative care experts, other surgeons. The scientific background of end of life care isn't really discussed in detail, as this film focuses more on the social and emotional aspects of this topic.

The central argument of the film is that healthcare professionals are for the most part believe that they can defeat most diseases, and that they consider not being able to fix something a failure on their part. As such, they are not trained well in handling palliative and end-of-life care, prioritizing the patients wishes and dignity over putting up a fight against the disease.

I found parts of the film where the narrator discusses his father to be particularly compelling, because the treatment course that the father took directly influenced how the narrator sees pallative and end of life care and provided a lense from which to look at the rest of the film.