Penalized Fair Regression for Multiple Groups in Chronic Kidney Disease

Demographic parity (DP) is a widely used group fairness criterion requiring predictive distributions to be invariant across sensitive groups. While natural in classification, full distributional DP is often overly restrictive in regression and can lead to substantial accuracy loss. We propose a relaxation of DP tailored to regression, enforcing parity only at a finite set of quantile levels and/or score thresholds. Concretely, we introduce a novel (${\ell}$, Z)-fair predictor, which imposes groupwise CDF constraints of the form F f |S=s (z m ) = ${\ell}$ m for prescribed pairs (${\ell}$ m , z m ). For this setting, we derive closed-form characterizations of the optimal fair discretized predictor via a Lagrangian dual formulation and quantify the discretization cost, showing that the risk gap to the continuous optimum vanishes as the grid is refined. We further develop a model-agnostic post-processing algorithm based on two samples (labeled for learning a base regressor and unlabeled for calibration), and establish finite-sample guarantees on constraint violation and excess penalized risk. In addition, we introduce two alternative frameworks where we match group and marginal CDF values at selected score thresholds. In both settings, we provide closed-form solutions for the optimal fair discretized predictor. Experiments on synthetic and real datasets illustrate an interpretable fairness-accuracy trade-off, enabling targeted corrections at decision-relevant quantiles or thresholds while preserving predictive performance.

Fairness-accuracy trade-offs are a central concern in the deployment of fairness-aware machine learning methods. When sensitive attributes are unavailable at inference time-the so called unawareness setting, principled methods for obtaining accurate predictions under relaxed fairness constraints are largely missing. In this work, we address this gap by formulating regression under a demographic parity penalty as an optimal transport problem. Our framework unifies both the aware and unaware settings and characterizes optimal prediction functions via optimal transport maps, under both squared Wasserstein-2 and Total Variation penalties. These results reveal that the choice of penalty reflects fundamentally different fairness philosophies: the Wasserstein penalty induces a smooth, population-wide compromise, while Total Variation enforces exact parity for a subset of individuals. Building on these theoretical characterizations, we propose an algorithm that is simple to implement, computationally efficient, and consistently matches or outperforms state-of-the-art baselines on real-world benchmarks.

Exact demographic parity requires the same prediction distribution across sensitive groups. In regression, this can be too restrictive and reduce predictive accuracy. We instead bound every pairwise Wasserstein distance between group-specific prediction distributions by a chosen tolerance, allowing the groups to differ while keeping fairness tunable. On the real line, the prediction and constrained transport problems have the same infimum. If the transport problem attains this value and suitable Monge maps exist, a deterministic transport-form predictor realizes it. Under a standard one-dimensional condition, the problem becomes a bounded quantile optimization that is convex when the conditional expected loss is convex in prediction. Under squared loss with two positively weighted groups, the $W_1$, $W_2$, and $W_\infty$ constraints yield soft-thresholding, shrinkage, and clipping. Under the stated conditions, we establish rates for the known-cost plug-in estimator. When the cost is unavailable, we describe an observed-loss computational proxy. Synthetic and California 2018 ACS studies illustrate the tunable fairness-accuracy trade-off and distinguish calibration feasibility from held-out fairness and accuracy.