Our research shows that where one lives—including pollution levels, neighborhood factors, and social conditions—can affect their psoriasis severity and whether they might have psoriatic arthritis. People with exposure to higher environmental risk or social vulnerability are more likely to have worse psoriasis outcomes. Understanding these susceptibility factors can help doctors and public health leaders find ways to better support and treat people in high-risk communities. This work may lead to new strategies to prevent psoriasis from getting worse and to reduce health disparities. It also highlights the importance of considering medical and non-medical factors in managing chronic skin conditions.