# From Awareness to Action: Understanding and Overcoming the Research-Practice Gap in Algorithmic Fairness for Public Health

arXiv: https://arxiv.org/abs/2606.11214 · HTML: https://mlsanity.com/paper/2606.11214/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 67 references that are in the map.
- First posted on arXiv 2 May 2026.

## Builds on (most cited first, 13 of 13)

- [Equality of Opportunity in Supervised Learning](https://mlsanity.com/paper/1610.02413/) (2016)
- [Datasheets for Datasets](https://mlsanity.com/paper/1803.09010/) (2018)
- [Model Cards for Model Reporting](https://mlsanity.com/paper/1810.03993/) (2018)
- [Certifying and removing disparate impact](https://mlsanity.com/paper/1412.3756/) (2014)
- [Confounding variables can degrade generalization performance of radiological deep learning models](https://mlsanity.com/paper/1807.00431/) (2018)
- [Fairness in Machine Learning: A Survey](https://mlsanity.com/paper/2010.04053/) (2020)
- [Improving fairness in machine learning systems: What do industry practitioners need?](https://mlsanity.com/paper/1812.05239/) (2018)
- [A Framework for Understanding Sources of Harm throughout the Machine Learning Life Cycle](https://mlsanity.com/paper/1901.10002/) (2019)
- [Ethical Machine Learning in Health Care](https://mlsanity.com/paper/2009.10576/) (2020)
- [Fairness Perceptions of Algorithmic Decision-Making: A Systematic Review of the Empirical Literature](https://mlsanity.com/paper/2103.12016/) (2021)
- [FUTURE-AI: Guiding Principles and Consensus Recommendations for Trustworthy Artificial Intelligence in Medical Imaging](https://mlsanity.com/paper/2109.09658/) (2021)
- [Unmasking Bias in AI: A Systematic Review of Bias Detection and Mitigation Strategies in Electronic Health Record-based Models](https://mlsanity.com/paper/2310.19917/) (2023)
- [Machine Learning and Public Health: Identifying and Mitigating Algorithmic Bias through a Systematic Review](https://mlsanity.com/paper/2510.14669/) (2025)

## Abstract (arXiv)

Algorithmic fairness is essential for responsible ML-driven public health research, yet its practical implementation remains limited. To investigate this awareness-action gap, we conducted a sequential mixed-methods study comprising expert interviews, an online survey, and systematic mapping. The expert interviews informed the design of the survey, which in turn revealed fragmented definitions of fairness, limited training and guidance, reliance on external sources, and rare use of formal assessment, mitigation, or monitoring. These findings were subsequently mapped onto three established research-practice gap lenses: the Knowledge-Practice Gap, the Knowledge-to-Action Cycle, and the Knowing-Doing Gap, each offering complementary perspectives. Building on this synthesis, we introduce the Fairness-to-Action framework, which integrates methodological, organizational, and systemic dimensions to identify where translation of algorithmic fairness knowledge stalls. Our analysis shows that fairness remains weakly institutionalized, translation mechanisms are externally driven, and system-level priorities continue to emphasize accuracy over fairness. These insights suggest critical leverage points for advancing safe, fair, and ethical ML-driven public health research practice.