Revisiting the social determinants of health with explainable AI: a cross-country perspective

In social science and epidemiological research, individual risk factors for mortality are often examined in isolation, while approaches that consider multiple risk factors simultaneously remain less common. Using the Health and Retirement Study in the US, the Survey of Health, Ageing and Retirement in Europe and the English Longitudinal Study of Ageing in the UK, we explore the predictability of death with machine learning and explainable AI algorithms, which integrate explanation and prediction simultaneously. Specifically, we extract information from all datasets in seven health-related domains including demographic, socioeconomic, psychology, social connections, childhood adversity, adulthood adversity, and health behaviours. Our self-devised algorithm reveals consistent domain-level patterns across datasets, with demography and socioeconomic factors being the most significant. However, at the individual risk-factor level, notable differences emerge, emphasising the context-specific nature of certain predictors.