Introduction: Socioeconomic status (SES), which indicates one’s access to financial, educational, and social resources, is a powerful determinant of health outcomes in multiple chronic diseases. Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in a single gene. Although life expectancy and quality of life for patients with CF have improved exponentially, disease severity varies substantially, even among individuals with identical genotypes. Areas covered: CF disease progression and outcomes are influenced by a number of nongenetic factors, such as material well-being, educational attainment, living and working conditions, physical environment and exposures, family environment, social support, health behaviors, and health care. This review discusses pathways by which financial, educational, and social resources are translated into health advantages in CF. Expert commentary: To achieve equitable CF outcomes, the contribution of nongenetic factors must be emphasized, highlighting the mechanisms through which the social and physical environments influence disease variability.