# Enhancing Multi-Attribute Fairness in Healthcare Predictive Modeling

arXiv: https://arxiv.org/abs/2501.13219 · HTML: https://mlsanity.com/paper/2501.13219/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 17 of its 30 references that are in the map.
- First posted on arXiv 22 Jan 2025.

## Builds on (most cited first, 17 of 17)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Equality of Opportunity in Supervised Learning](https://mlsanity.com/paper/1610.02413/) (2016)
- [A Survey on Bias and Fairness in Machine Learning](https://mlsanity.com/paper/1908.09635/) (2019)
- [Man is to Computer Programmer as Woman is to Homemaker? Debiasing Word Embeddings](https://mlsanity.com/paper/1607.06520/) (2016)
- [Mitigating Unwanted Biases with Adversarial Learning](https://mlsanity.com/paper/1801.07593/) (2018)
- [A Reductions Approach to Fair Classification](https://mlsanity.com/paper/1803.02453/) (2018)
- [Inherent Trade-Offs in the Fair Determination of Risk Scores](https://mlsanity.com/paper/1609.05807/) (2016)
- [A comparative study of fairness-enhancing interventions in machine learning](https://mlsanity.com/paper/1802.04422/) (2018)
- [Fairness Under Unawareness: Assessing Disparity When Protected Class Is Unobserved](https://mlsanity.com/paper/1811.11154/) (2018)
- [A Confidence-Based Approach for Balancing Fairness and Accuracy](https://mlsanity.com/paper/1601.05764/) (2016)
- [Creating Fair Models of Atherosclerotic Cardiovascular Disease Risk](https://mlsanity.com/paper/1809.04663/) (2018)
- [Addressing Fairness in Classification with a Model-Agnostic Multi-Objective Algorithm](https://mlsanity.com/paper/2009.04441/) (2020)
- [How fair can we go in machine learning? Assessing the boundaries of fairness in decision trees](https://mlsanity.com/paper/2006.12399/) (2020)
- [Optimising Equal Opportunity Fairness in Model Training](https://mlsanity.com/paper/2205.02393/) (2022)
- [FairMask: Better Fairness via Model-based Rebalancing of Protected Attributes](https://mlsanity.com/paper/2110.01109/) (2021)
- [Fair Regression for Health Care Spending](https://mlsanity.com/paper/1901.10566/) (2019)
- [Explainable AI for Fair Sepsis Mortality Predictive Model](https://mlsanity.com/paper/2404.13139/) (2024)

## Built on by (most cited first, 2 of 2)

- [Intra-Fairness Dynamics: The Bias Spillover Effect in Targeted LLM Alignment](https://mlsanity.com/paper/2602.16438/) (2026)
- [Penalized Fair Regression for Multiple Groups in Chronic Kidney Disease](https://mlsanity.com/paper/2512.17340/) (2025)

## Abstract (arXiv)

Artificial intelligence (AI) systems in healthcare have demonstrated remarkable potential to improve patient outcomes. However, if not designed with fairness in mind, they also carry the risks of perpetuating or exacerbating existing health disparities. Although numerous fairness-enhancing techniques have been proposed, most focus on a single sensitive attribute and neglect the broader impact that optimizing fairness for one attribute may have on the fairness of other sensitive attributes. In this work, we introduce a novel approach to multi-attribute fairness optimization in healthcare AI, tackling fairness concerns across multiple demographic attributes concurrently. Our method follows a two-phase approach: initially optimizing for predictive performance, followed by fine-tuning to achieve fairness across multiple sensitive attributes. We develop our proposed method using two strategies, sequential and simultaneous. Our results show a significant reduction in Equalized Odds Disparity (EOD) for multiple attributes, while maintaining high predictive accuracy. Notably, we demonstrate that single-attribute fairness methods can inadvertently increase disparities in non-targeted attributes whereas simultaneous multi-attribute optimization achieves more balanced fairness improvements across all attributes. These findings highlight the importance of comprehensive fairness strategies in healthcare AI and offer promising directions for future research in this critical area.