Fair Machine Learning for Healthcare Requires Recognizing the Intersectionality of Sociodemographic Factors, a Case Study

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Main Authors: Valentine, Alissa A., Charney, Alexander W., Landi, Isotta
Format: Preprint
Published: 2024
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author Valentine, Alissa A.
Charney, Alexander W.
Landi, Isotta
author_facet Valentine, Alissa A.
Charney, Alexander W.
Landi, Isotta
contents As interest in implementing artificial intelligence (AI) in medical systems grows, discussion continues on how to evaluate the fairness of these systems, or the disparities they may perpetuate. Socioeconomic status (SES) is commonly included in machine learning models to control for health inequities, with the underlying assumption that increased SES is associated with better health. In this work, we considered a large cohort of patients from the Mount Sinai Health System in New York City to investigate the effect of patient SES, race, and sex on schizophrenia (SCZ) diagnosis rates via a logistic regression model. Within an intersectional framework, patient SES, race, and sex were found to have significant interactions. Our findings showed that increased SES is associated with a higher probability of obtaining a SCZ diagnosis in Black Americans ($β=4.1\times10^{-8}$, $SE=4.5\times10^{-9}$, $p < 0.001$). Whereas high SES acts as a protective factor for SCZ diagnosis in White Americans ($β=-4.1\times10^{-8}$, $SE=6.7\times10^{-9}$, $p < 0.001$). Further investigation is needed to reliably explain and quantify health disparities. Nevertheless, we advocate that building fair AI tools for the health care space requires recognizing the intersectionality of sociodemographic factors.
format Preprint
id arxiv_https___arxiv_org_abs_2407_15006
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Fair Machine Learning for Healthcare Requires Recognizing the Intersectionality of Sociodemographic Factors, a Case Study
Valentine, Alissa A.
Charney, Alexander W.
Landi, Isotta
Computers and Society
Machine Learning
As interest in implementing artificial intelligence (AI) in medical systems grows, discussion continues on how to evaluate the fairness of these systems, or the disparities they may perpetuate. Socioeconomic status (SES) is commonly included in machine learning models to control for health inequities, with the underlying assumption that increased SES is associated with better health. In this work, we considered a large cohort of patients from the Mount Sinai Health System in New York City to investigate the effect of patient SES, race, and sex on schizophrenia (SCZ) diagnosis rates via a logistic regression model. Within an intersectional framework, patient SES, race, and sex were found to have significant interactions. Our findings showed that increased SES is associated with a higher probability of obtaining a SCZ diagnosis in Black Americans ($β=4.1\times10^{-8}$, $SE=4.5\times10^{-9}$, $p < 0.001$). Whereas high SES acts as a protective factor for SCZ diagnosis in White Americans ($β=-4.1\times10^{-8}$, $SE=6.7\times10^{-9}$, $p < 0.001$). Further investigation is needed to reliably explain and quantify health disparities. Nevertheless, we advocate that building fair AI tools for the health care space requires recognizing the intersectionality of sociodemographic factors.
title Fair Machine Learning for Healthcare Requires Recognizing the Intersectionality of Sociodemographic Factors, a Case Study
topic Computers and Society
Machine Learning
url https://arxiv.org/abs/2407.15006