Causal Links Between Climatic and Socioeconomic Drivers Shaping AMR

Antimicrobial resistance (AMR) is a rapidly escalating global health crisis threatening human, animal, and environmental well-being. While its spread is often linked to antibiotic use, the complex, nonlinear nature of its environmental and socioeconomic drivers remains poorly understood, rendering traditional analyses insufficient. This study moves beyond simple correlation to investigate the causal relationships between four distinct E. coli resistance phenotypes and key socioeconomic and climatic factors across the United States, employing the powerful Peter and Clark Momentary Conditional Independence (PCMCI) and Transfer Entropy (TE) methods. This analysis reveals a highly heterogeneous landscape of AMR dynamics, where causal drivers differ significantly by both phenotype and geographical location. Results show that drivers such as extreme temperatures, precipitation, and income levels exert significant causal effects on AMR in specific states, demonstrating that this crisis is intrinsically linked to climatic and socioeconomic conditions, not just healthcare practices. These findings point to the urgent need for dynamic, phenotype-specific, and regionally tailored strategies developed under a One Health lens, highlighting that only a multidisciplinary approach can truly address the complexity of AMR.