Although popularized AI fairness metrics, e.g., demographic parity, have uncovered bias in AI-assisted decision-making outcomes, they do not consider how much effort one has spent to get to where one is today in the input feature space. However, the notion of effort is important in how Philosophy and humans understand fairness. We propose a philosophy-informed approach to conceptualize and evaluate Effort-aware Fairness (EaF), grounded in the concept of Force, which represents the temporal trajectory of predictive features coupled with inertia. Besides theoretical formulation, our empirical contributions include: (1) a pre-registered human subjects experiment, which shows that for both stages of the (individual) fairness evaluation process, people consider the temporal trajectory of a predictive feature more than its aggregate value; (2) pipelines to compute Effort-aware Individual/Group Fairness in the criminal justice and personal finance contexts. Our work may enable AI model auditors to uncover and potentially correct unfair decisions against individuals who have spent significant efforts to improve but are still stuck with systemic disadvantages outside their control.

The rising rate of drug-related deaths in the United States, largely driven by fentanyl, requires timely and accurate surveillance. However, critical overdose data are often buried in free-text coroner reports, leading to delays and information loss when coded into ICD (International Classification of Disease)-10 classifications. Natural language processing (NLP) models may automate and enhance overdose surveillance, but prior applications have been limited. A dataset of 35,433 death records from multiple U.S. jurisdictions in 2020 was used for model training and internal testing. External validation was conducted using a novel separate dataset of 3,335 records from 2023-2024. Multiple NLP approaches were evaluated for classifying specific drug involvement from unstructured death certificate text. These included traditional single- and multi-label classifiers, as well as fine-tuned encoder-only language models such as Bidirectional Encoder Representations from Transformers (BERT) and BioClinicalBERT, and contemporary decoder-only large language models such as Qwen 3 and Llama 3. Model performance was assessed using macro-averaged F1 scores, and 95% confidence intervals were calculated to quantify uncertainty. Fine-tuned BioClinicalBERT models achieved near-perfect performance, with macro F1 scores >=0.998 on the internal test set. External validation confirmed robustness (macro F1=0.966), outperforming conventional machine learning, general-domain BERT models, and various decoder-only large language models. NLP models, particularly fine-tuned clinical variants like BioClinicalBERT, offer a highly accurate and scalable solution for overdose death classification from free-text reports. These methods can significantly accelerate surveillance workflows, overcoming the limitations of manual ICD-10 coding and supporting near real-time detection of emerging substance use trends.