Causal Estimation of Exposure Shifts with Neural Networks: Evaluating the Health Benefits of Stricter Air Quality Standards in the US

In policy research, one of the most critical analytic tasks is to estimate the causal effect of a policy-relevant shift to the distribution of a continuous exposure/treatment on an outcome of interest. We call this problem shift-response function (SRF) estimation. Existing neural network methods involving robust causal-effect estimators lack theoretical guarantees and practical implementations for SRF estimation. Motivated by a key policy-relevant question in public health, we develop a neural network method and its theoretical underpinnings to estimate SRFs with robustness and efficiency guarantees. We then apply our method to data consisting of 68 million individuals and 27 million deaths across the U.S. to estimate the causal effect from revising the US National Ambient Air Quality Standards (NAAQS) for PM 2.5 from 12 $\mu g/m^3$ to 9 $\mu g/m^3$. This change has been recently proposed by the US Environmental Protection Agency (EPA). Our goal is to estimate, for the first time, the reduction in deaths that would result from this anticipated revision using causal methods for SRFs. Our proposed method, called {T}argeted {R}egularization for {E}xposure {S}hifts with Neural {Net}works (TRESNET), contributes to the neural network literature for causal inference in two ways: first, it proposes a targeted regularization loss with theoretical properties that ensure double robustness and achieves asymptotic efficiency specific for SRF estimation; second, it enables loss functions from the exponential family of distributions to accommodate non-continuous outcome distributions (such as hospitalization or mortality counts). We complement our application with benchmark experiments that demonstrate TRESNET's broad applicability and competitiveness.