The United States has allocated approximately $65 billion through the Infrastructure Investment and Jobs Act for broadband expansion, yet evidence-based methods for targeting these investments remain underdeveloped. This paper presents an explainable machine learning framework for profiling broadband adoption disparities at census-tract granularity across 83,359 tracts nationwide. Using 65 socioeconomic, demographic, and infrastructure features derived from the American Community Survey 2022, we train a LightGBM model under spatial five-fold cross-validation, achieving R^2 = 0.533 and Spearman rho = 0.763; state-held-out cross-validation (51 folds) confirms generalization (R^2 = 0.525). TreeSHAP analysis identifies income and education as the dominant factor group (with the engineered interaction term absorbing attribution from its constituent features), and SHAP-based clustering reveals three exploratory factor profiles: Well-Connected Moderate (~49K tracts), Affordability-Limited Severe (~21K tracts), and Rural-Elderly (~13K tracts). As a screening tool, ML-based tract selection captures 38.0% of the total adoption gap within the top 10% of tracts versus 35.2% for income-only heuristics (+2.8 pp, p < 0.002, county-block bootstrap); in regret-reduction terms, the model closes 19% of the remaining gap between income-only and oracle selection. The primary contribution is the per-tract factor decomposition: SHAP identifies which feature groups (income/education, rurality, age) are most strongly associated with each tract's predicted gap, and informs differentiated investigation. A temporal stability check, training on ACS 2017 and predicting ACS 2022 with zero survey-year overlap, confirms ranking stability (rho = 0.784, noting hyperparameters tuned on 2022 data).
Social disadvantage is associated with multimorbidity, but the pathways linking social conditions to disease burden remain poorly understood. We developed an AI-driven multimodal mediation framework that integrates socioeconomic, psychosocial, clinical, laboratory, behavioral, and genomic data from the All of Us Research Program. Modality-specific variational autoencoders were used to derive latent representations of each data domain, and mediation analyses were subsequently performed in latent space to evaluate indirect associations between socioeconomic disadvantage, psychosocial factors, and multimorbidity. The final analytic cohort included 20,804 participants with complete multimodal data. Across 800 exposure--mediator--outcome combinations, mediation signals were concentrated within a small number of latent dimensions. The strongest indirect association linked a socioeconomic disadvantage dimension, a psychosocial vulnerability dimension, and a cardiometabolic multimorbidity dimension (NIE = 0.002517). The psychosocial dimension was characterized by poorer mental health, greater loneliness, lower social well-being, and lower health literacy, whereas the outcome dimension was associated with hypertension, diabetes, hyperlipidemia, obesity, chronic kidney disease, and heart disease. Bootstrap analyses supported the stability of the leading pathway. These findings suggest that psychosocial vulnerability was strongly represented in the dominant latent pathway linking socioeconomic disadvantage and cardiometabolic multimorbidity. More broadly, the proposed framework illustrates how AI-based representation learning can be used to investigate complex relationships across high-dimensional multimodal health data.