We analysed a large health insurance dataset to assess the genetic and environmental contributions of 560 disease-related phenotypes in 56,396 twin pairs and 724,513 sibling pairs out of 44,859,462 individuals that live in the United States. We estimated the contribution of environmental risk factors (socioeconomic status (SES), air pollution and climate) in each phenotype. Mean heritability (h2 = 0.311) and shared environmental variance (c2 = 0.088) were higher than variance attributed to specific environmental factors such as zip-code-level SES (varSES = 0.002), daily air quality (varAQI = 0.0004), and average temperature (vartemp = 0.001) overall, as well as for individual phenotypes. We found significant heritability and shared environment for a number of comorbidities (h2 = 0.433, c2 = 0.241) and average monthly cost (h2 = 0.290, c2 = 0.302). All results are available using our Claims Analysis of Twin Correlation and Heritability (CaTCH) web application.
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The data that support the findings of this study are available from Aetna Insurance, but restrictions apply to the availability of these data, which were used under licence for the current study, and so are not publicly available. Please contact N. Palmer (email@example.com) for inquiries about the Aetna dataset. Summary data are, however, available from the authors upon reasonable request and with permission of Aetna Insurance. Code for analysis, generation of figures and figure files is available at https://github.com/cmlakhan/twinInsurance.
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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We thank K. Fox of Aetna, Inc., N. Palmer of Harvard Medical School, and I. Kohane of Harvard Medical School for support and providing access to the Aetna Insurance Claims Data. We are grateful to L. O’Connor and A. Price for helpful discussion. This research was supported by the Australian National Health and Medical Research Council (1078037 and 1113400), National Institutes of Health NIEHS (R00ES23504 and R21ES205052), the National Science Foundation (1636870), and the Sylvia & Charles Viertel Charitable Foundation.