Advancing Health Equity through Multi-Level Fairness in Health Informatics

Abstract

The increasing integration of machine learning in healthcare has highlighted critical challenges related to fairness, transparency, and health equity. Specifically, the use of multi-level fairness techniques, which combine multiple bias mitigation steps or techniques, show promise for reducing biases across different patient demographics, yet this approach remains underexplored in terms of its health equity outcomes. In this paper, we assess the current landscape of multi-level fairness in health informatics by focusing on its impact on equitable healthcare outcomes and evaluating how transparency and reporting standards contribute to these advancements. Through an examination of the existing literature, we identify key gaps in both the implementation of multi-level fairness techniques and the consistent reporting of health equity impacts. Furthermore, we analyze the role of reporting standards, including MINIMAR and TRIPOD, in improving model transparency and ensuring that machine learning models in healthcare address health disparities. These standards offer valuable benchmarks for reporting on ML models, yet we identify key opportunities for enhancing how these reports capture fairness and equity outcomes. The paper concludes by providing recommendations that focus on improving transparency in reporting, advocating for the broader adoption of multi-level fairness techniques, and ensuring that health equity is explicitly prioritized in future research efforts.