public health planners

Abstract: Can AI contribute to formal demography? We report an experiment in which an AI model, Claude, was asked to explain and then simplify the proof of an earlier result: that vaccinating the oldest against COVID-19 saves both the most lives and the most years of life, because the years saved per person treated rise with age. The model proposed a new proof that is shorter, more intuitive, and somewhat more general than the original, built from a known life-table identity and the definition of convexity. It states the condition for the result as the convexity of the reciprocal of the hazard, which can be checked from the hazard alone and holds for most familiar parametric models, and it yields a lower bound on life expectancy whenever that condition is met. Prompted by a further question, the model also gave an exact form of the condition, showing how far convexity can be relaxed. The model traced these identities and related results in earlier literature. An edited record of the sessions is provided, and complete transcripts are available on request. The exercise suggests that AI can revisit established results, make them easier to understand, and prove valuable generalizations.

Abstract: Groundwater in Ghana's Densu River Basin remains a key domestic water source, but multi-metal contamination threatens children's health. Previous deterministic hazard index assessments provide limited treatment of uncertainty, co-exposure, and spatial variability. This study applies a Bayesian probabilistic framework for non-carcinogenic risk assessment using 94 groundwater samples and measurements of Fe, Mn, Ni, Pb, Cd, and As. A Bayesian regression model propagates parameter uncertainty and accounts for contaminant co-occurrence. Adaptive Hamiltonian Monte Carlo is used for posterior inference, while inverse distance weighting generates spatially continuous risk surfaces. Pb, As, and Cd dominate cumulative risk. Posterior predictive results indicate that approximately 31% of sampling sites have a probability greater than 0.5 of exceeding a hazard index (HI) of 1. The risk surface is highly heterogeneous, with a posterior mean of 0.372 and a standard deviation of 0.416. High-risk zones often reflect moderate co-exposure rather than extreme contamination by a single metal. The framework provides uncertainty-aware, spatially explicit information to support groundwater monitoring, risk mitigation, and public health planning in data-limited regions.

Abstract: Personalized public-health targeting must capture heterogeneous intervention benefits while remaining interpretable under resource constraints. Flexible causal-effect models can be hard to operationalize, while coarse subgroup policies may lose individualized effect information. We study budget-constrained hypothetical state interventions in observational data without a logged historical decision policy. For obesity, elevated glucose, and lifetime smoking-history states, causal-structure-informed pretreatment covariates are prespecified, with capacity capped at 70% of those observed in the adverse state. We evaluate causal distillation where Causal Forest and Bayesian Causal Forest teachers estimate conditional average treatment effects (CATEs), which decision tree and random forest students approximate. We compare individualized policies with unsupervised K-means subgroup policies and supervised causal-tree policies with leaf counts matched to K-means cluster counts. Observational policies are assessed on held-out data using a doubly robust estimator, bootstrap uncertainty, and decision-focused teacher-student fidelity measures. Across PIMA obesity and glucose and NHANES smoking-history experiments, each distilled student was within 0.011 absolute utility of its teacher, with allocation Jaccard similarities of 0.738-0.937. K-means and causal-tree policies were also competitive, with the highest point-estimate policy varying by application. Prespecified paired comparisons were nonsignificant after Holm adjustment, while near-budget-boundary agreement was less stable than global fidelity for some teacher-student pairs. Findings support causal distillation for translating flexible effect models into simpler budgeted targeting rules, although observational estimates depend on causal-identification assumptions and require longitudinal or prospective validation.

Abstract: Co-circulating influenza, COVID-19, and respiratory syncytial virus (RSV) create a shared hospital-admission burden, because beds, staff, testing capacity, and respiratory support are allocated to total demand rather than to one pathogen at a time. This makes respiratory forecasting a target-construction problem as well as a modeling problem: disease-specific forecasts preserve attribution, whereas hospitals also need a single planning signal for combined burden. We developed a supervised 1- to 4-week-ahead framework for weekly admissions and compared two total-burden strategies: summing independently generated pathogen-specific forecasts and forecasting the combined admission target directly. Evaluation included retrospective held-out testing and prospective operational forecasts issued before the corresponding admission weeks were observed, with performance summarized using MAE and Percent Agreement (PA; the smaller of model-generated and observed counts divided by the larger). In retrospective total-burden evaluation, the combined-burden model had PA values of 0.85, 0.78, 0.74, and 0.76 and MAE values of 80.63, 200.09, 183.97, and 156.13 from week 1 to week 4 ahead, compared with summed-forecast PA values of 0.85, 0.80, 0.69, and 0.69 and MAE values of 100.14, 200.06, 205.65, and 217.57. Prospectively, the combined-burden model had higher PA and lower MAE at all four horizons, with the largest separations at weeks 3 and 4 ahead. These results support layered respiratory forecasting: pathogen-specific forecasts remain necessary for etiologic interpretation, while combined-burden forecasts better align with hospital preparedness and shared-capacity planning.

Abstract: A growing body of evidence suggests that political polarization and mental health and wellbeing influence each other. Yet the two directions, how polarization shapes mental wellbeing and how mental wellbeing shapes polarization, remain siloed across disciplines. We review both literatures to evaluate the strength and alignment of evidence for bidirectional effects. We find that the literature varies widely in constructs, measures, and levels of analysis, and that the evidence for the two pathways is asymmetric: links from polarization to mental wellbeing are more direct, grounded in well-developed theoretical frameworks and social-relational mechanisms. In contrast, the reverse pathway is substantially less direct, with studies often examining cognitive and socio-emotional factors, or political outcomes adjacent to polarization rather than polarization itself. We identify clear gaps in the literature highlighting the need for future studies with conceptual clarity, unified frameworks, validated measures, and multilevel designs examining both pathways within the same empirical and theoretical setting.

Abstract: During epidemics, limited resources dictate critical decisions about whom to isolate or monitor. Conventional public health strategies intuitively prioritize known infected individuals and their immediate contacts. Here, we reveal that this contact-centric approach is fundamentally suboptimal under realistic resource constraints. By formulating this challenge as target-aware network dismantling, we uncover a counter-intuitive, budget-dependent intervention transition. Generating-function analysis demonstrates that when intervention budgets are scarce, isolating structurally central individuals, rather than the immediate neighbours of the infected, protects a vastly larger population. The conventional neighbour-targeting strategy only becomes optimal as available resources increase. Because this critical transition point shifts dynamically with the intervention budget, network topology, and spatial distribution of infections, static strategies inevitably fail. To overcome this, we develop Risk-Aware Isolation Learning (RAIL), a deep reinforcement learning framework that adaptively selects optimal interventions based on the evolving residual network. Across diverse synthetic and real-world networks, RAIL consistently maximizes population protection and suppresses outbreak spread. Ultimately, our findings challenge prevailing epidemiological intuitions, establishing a generalizable framework for adaptive interventions against localized risks in public health and other complex systems.

Abstract: Evaluating network interventions requires understanding how treatment affects people through their social relationships. Counting treated neighbors without distinguishing supportive and antagonistic ties can conceal opposing influences. We define effects through positive and negative ties, their interaction, and a sign-composition effect of reallocating treatment between the two types at a fixed total, and give their identification formulas. Under sign-blind assignment, we show how ignoring signs mixes the effects of the two tie types. We propose SiDE (Signed-exposure Doubly robust Estimator), which combines sign-specific outcome models with exposure probabilities induced by individual treatment assignment. We establish double robustness of its score and assess approximate intervals that account for overlapping neighborhoods. Semi-synthetic experiments on six real signed networks demonstrate accurate effect estimation and examine the limits of interval coverage. An exploratory reanalysis of published school-experiment data yields a positive estimate of the peer effect through spend-time ties on wristband wearing, but the intervals for all four effects include zero after adjustment for multiple comparisons. This framework can inform network intervention design by showing when influences through the two tie types reinforce or offset one another.

Abstract: Epidemic policy planning often requires coordination between geographical regions, taking into account mobility-driven spillovers and how to make use of limited resources. Existing methods either lack action-conditioned models of coupled dynamics or cannot guarantee per-period feasibility. We present EpiMind, a graph world model framework for constrained epidemic policy planning across regions. A graph-factored recurrent state-space model generates joint policy-conditioned rollouts from regional latent beliefs, while graph-temporal ADMM optimizes regional interventions, enforces shared-resource feasibility through projection, and evaluates temporal specifications under the learned model. EpiMind reduces admission RMSE by 29% relative to graph-free dynamics modeling, plans within 1-5% of the best feasible constant policy with guaranteed shared-budget feasibility, and outperforms all deployable baselines across three resource budgets in real-context evaluation. These results demonstrate that graph-structured policy imagination with explicit constrained coordination supports effective epidemic interventions from learned dynamics.

Abstract: Mass gathering events like concerts, sports matches, and festivals bring many people into close contact within a short period, creating localized bursts of infection that can shape epidemic outcomes across an entire city. To evaluate how these transient transmission events translate into broader urban impacts, we developed a simulation model linking event-scale contact dynamics with citywide commuting networks. Using Madrid, Spain, as a case study, we compared several types of gatherings and examined how their effects changed under different levels of disease transmissibility. We found that mass gatherings consistently amplified outbreak magnitude, accelerated progression, advanced district-level arrival times, and synchronized spatial spread. Remarkably, while the initial seed size generated at the event accounted for much of this acceleration, post-event transmission conditions provided complementary predictive signal regarding invasion timing. These findings demonstrate that mitigating transmission during mass gatherings can yield downstream public health benefits by delaying broader spatial spread. More generally, this multiscale framework offers a tool to evaluate how temporary, localized contact shifts produce longer-lasting consequences for urban populations.

Abstract: Identifying the minimal set of nodes whose removal breaks a complex network apart, also referred as the network dismantling problem, is a highly non-trivial task with applications in multiple domains. Whereas network dismantling has been extensively studied over the past decade, research has primarily focused on the formulations of the optimization problem for single-layer networks, neglecting that many, if not all, real networks display multiple layers of interdependent interactions. In such networks, the optimization problem is fundamentally different as the effect of removing nodes propagates within and across layers in a way that can not be predicted using a single-layer perspective. Here, we propose a dismantling algorithm named MultiDismantler, which leverages multiplex network representation and deep reinforcement learning to optimally dismantle multi-layer interdependent networks. MultiDismantler is trained on small synthetic multiplex graphs; when applied to large, real and synthetic networks, it displays exceptional dismantling performance, clearly outperforming all existing methods that rely on a single-layer approach to network dismantling. We show that MultiDismantler is effective in guiding strategies for the containment of diseases in social networks characterized by multiple layers of social interactions. Also, we show that MultiDismantler is useful in the design of protocols aimed at delaying the onset of cascading failures in interdependent critical infrastructures.

Abstract: Childhood stunting remains a major public health concern in Bangladesh and reflects long-term growth failure influenced by child, maternal, household, socioeconomic, and health-service factors. This study used nationally representative Bangladesh Demographic and Health Survey data from 2007 to 2022 to develop machine learning models for population-level prediction of childhood stunting and to assess temporal robustness and subgroup fairness. Children aged 0-59 months with complete anthropometric and predictor data were included. Data from the 2007, 2011, and 2014 survey rounds were used for model development, while the 2018 and 2022 rounds were retained as temporal test datasets. Twelve feature-selection approaches were assessed, and the KNN permutation importance-selected predictor set was used for final model evaluation. Eleven machine learning models were evaluated: ten conventional algorithms and one pretrained tabular foundation model, TabPFN. Performance was assessed using balanced accuracy, AUROC, F1-score, Brier score, and expected calibration error. Subgroup fairness was examined by child sex, place of residence, and socioeconomic status. The final analytic sample included 18,844 children, of whom 35.05% were stunted. In the development hold-out test dataset, TabPFN showed the highest observed balanced accuracy overall at 67.58%, while AdaBoost showed the highest observed balanced accuracy among conventional models at 67.51%. In temporal testing, the highest observed balanced accuracy was found for Gradient Boosting in BDHS 2018 and XGBoost in BDHS 2022. Model performance varied across survey rounds and subgroups, highlighting the importance of temporal validation, subgroup fairness assessment, and transparent interpretation in public health prediction modeling.

Abstract: The COVID-19 pandemic has had profound impacts on global health, social structures, and economies. It disproportionately affected lower socioeconomic groups and those reliant on interaction-based jobs. Regulatory bodies faced the challenge of designing policies that preserve public health while limiting disruption to economic stability and productivity. Epidemiological models such as SIR and agent-based models (ABMs) have been used to study disease dynamics and the socioeconomic impacts of disease and interventions. Population-level models often simplify individual heterogeneity, while detailed ABMs can become computationally expensive as the numbers of agents and interactions increase. We propose ABM-SIRTEM, a hybrid model that incorporates occupation categories, economic productivity, and welfare at the individual level while dynamically modeling compliance with government interventions. We calibrate the model against historical positive and negative test counts from four U.S. states and examine the resulting compliance dynamics. This framework provides a basis for studying the interaction between disease spread and socioeconomic behavior in pandemic-response planning.

Abstract: The Minimum Dominating Set (MDS) problem is a classic NP-hard combinatorial optimization problem with critical applications in social network analysis, including viral marketing, influence maximization, public health interventions, and information dissemination. Identifying a minimal set of influential individuals whose reach covers an entire social network is central to these applications, yet remains computationally challenging at scale. Graph neural networks (GNNs) have emerged as powerful tools for learning over graphs, and recent work explores their application to hard combinatorial problems. This paper presents a novel unsupervised GNN framework for the MDS problem that eliminates the need for ground-truth solutions during training. Trained on 12,000 synthetic graphs with diverse structural properties, our method achieves up to 55x faster inference than metaheuristic baselines and up to 14x faster inference than supervised learning approaches, while finding optimal or near-optimal dominating sets on real-world social network benchmarks. Our learned heuristic generalizes effectively to unseen graph distributions, demonstrating strong practical applicability for large-scale social network analysis.