Study Finds Social Determinants of Health Can Match or Exceed Genetic Risk in Predicting Common Diseases
Life circumstances add important insight beyond genetics alone
A new study from the Icahn School of Medicine at Mount Sinai shows that social determinants of health—including environmental conditions, health behaviors, access to resources, and social well-being—can play an equally important or even greater role than genetics in predicting a person’s risk of developing common diseases.
Published in the June 22 online issue of The American Journal of Human Genetics [DOI: 10.1016/j.ajhg.2026.05.014], the study, titled "Integrating Social Determinants of Health and Genetic Risk in Disease Risk Models," examined how inherited genetic risk and social, behavioral, and environmental factors interact to influence disease risk across diverse populations.
Using data from the All of Us Research Program—a nationwide National Institutes of Health (NIH) initiative—researchers analyzed genetic information, electronic health records, and survey responses from participants across the United States. They evaluated six common conditions: asthma, chronic kidney disease, coronary heart disease, high cholesterol, breast cancer, and prostate cancer.
The researchers found that incorporating social determinants of health significantly improved disease risk prediction beyond genetics alone. For four of the six diseases studied, social, behavioral, and environmental factors contributed as much as, or more than, commonly used genetic risk scores.
"Genes are an important part of the equation, but they do not determine destiny," says senior corresponding author Samira Asgari, PhD, Assistant Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai. "We found that the circumstances of people's lives—their environments, behaviors, and social experiences—can contribute as much as genetics to predicting disease risk. To truly understand health, we have to look at the whole person, not just their DNA."
The findings highlight the complex factors that shape health and disease. While advances in genetics have expanded researchers' ability to estimate inherited risk, the new findings suggest that combining genetic information with social and environmental context may provide a more complete understanding of disease risk and help inform future prevention strategies.
To conduct the study, researchers analyzed more than 100 survey-based and community-level measures related to social and environmental conditions. Rather than focusing on a handful of predefined risk factors, the team developed a framework that identifies broader patterns across many aspects of people's lives and evaluates how those patterns contribute to disease risk.
Among the notable findings, the researchers observed associations between disease risk and factors that are less frequently examined in genetic and biological research, including loneliness. While the study was not designed to determine cause and effect, the findings highlight areas that warrant further investigation.
"Some risk factors, such as smoking, have been studied extensively for decades,” says first author Abhijith Biji, a PhD student in the Asgari lab who led the work. "What is especially intriguing is that we also observed associations involving factors like loneliness. Understanding how these experiences may become biologically embedded could open new avenues for research and ultimately improve our understanding of disease."
The authors emphasize that the study does not identify simple causes of disease and should not be interpreted as showing that any single factor directly leads to illness. Also, because many of the survey responses were collected at a single point in time, the research cannot determine whether a particular factor preceded the onset of disease.
Instead, the researchers say, the study provides a framework for integrating genetic and non-genetic information to build more comprehensive disease risk models.
The researchers believe this approach could strengthen population health research, improve disease prevention strategies, enhance risk assessment, and support future efforts to develop more personalized approaches to health care. Future studies will explore how social determinants of health can be integrated with additional biological measures and investigate the biological mechanisms that may connect social experiences to disease.
"Our goal is to build a more complete understanding of health and disease," says Dr. Asgari. "By combining genetics with social and environmental context, we can move toward risk models that better reflect the realities of people's lives and help advance more personalized approaches to health."
The authors, as listed in the journal, are Abhijith Biji, Kathleen Ferar, Vikas Pejaver, Eimear E. Kenny, Bian Liu, and Samira Asgari.
This work was supported in part by NIH grants: R21MD019104 and R35GM160530 and the Clinical and Translational Science Awards (CTSA) grant UL1TR004419 from the National Center for Advancing Translational Sciences. Research reported in the publication was also supported by the Office of Research Infrastructure of the National Institutes of Health under award numbers S10OD026880 and S10OD030463.
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the seven member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City’s large and diverse patient population.
The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master’s degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,700 clinical residents and fellows training throughout the Health System. The Graduate School of Biomedical Sciences offers 13 degree-granting programs, conducts innovative basic and translational research, and trains more than 470 postdoctoral research fellows.
Ranked 11th nationwide in National Institutes of Health (NIH) funding, the Icahn School of Medicine at Mount Sinai is among the 90th percentile of U.S. private medical schools in Sponsored Programs Direct Expenditures per Principal Investigator, according to the Association of American Medical Colleges. More than 6,900 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.
-------------------------------------------------------
* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with approximately 48,000 employees working across seven hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and leading schools of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care from conception through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians and 10 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals,” “Best in State Hospitals,” “World’s Best Hospitals,” and “Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2025-2026.
For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Instagram, LinkedIn, X, and YouTube. To listen to news and stories from Mount Sinai, visit the Mount Sinai Podcast Network.