This article critiques the effort to disentangle genetic from social causes of disease, but also argues that rough assessments of the relative effect each set of factors makes in shaping patterns of disease and inequities is both possible and is ethically recommended. The essay is divided into two main sections. The first provides the theoretical critique of the genetic-social causal dichotomy as to disease. The second offers the empirical critique of the same dichotomy, and moves on to consider the implications of this empirical evidence for priority-setting in public health policy. Ultimately, because theoretical and empirical considerations suggest that social causes are of much greater significance than genetic causes in causing disease and inequities in populations, even where measures intended to address both sets of causes should be supported, greater resources and attention should be directed to influencing social causes than genetic causes.