Opportunities and challenges of artificial intelligence in public health: a systematic review on technological efficacy, ethical dilemmas, and governance pathways

Artificial intelligence (AI) holds profound potential to reshape public health through enhanced disease prediction, diagnosis, and health management. However, this technological advancement is accompanied by significant ethical, social, and governance challenges. This systematic review aims to comprehensively examine the opportunities and challenges of AI in public health, focusing on its applications, associated dilemmas, and governance pathways.

This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was performed across multiple databases (e.g., PubMed, Web of Science, Scopus, IEEE Xplore, CNKI, Wanfang) from January 2019 to January 2025. The PICOS framework guided the inclusion of studies addressing AI applications in public health functions, their outcomes, and ethical or governance aspects. From an initial 901 records, 136 studies were included in the qualitative synthesis after screening and quality assessment using tools such as the Newcastle-Ottawa Scale and CASP checklist.