Not every disorder depend on genes mutation. Even in congenital diseases (those originated before birth), you should try to make the difference among diseases of environmental origin, genetic origin anf inherited origin. In many cases, the three categories of factors have an important influence...
Mutations create alternative form of gene , so we have many alleles can be found in certain locus , in other hand natural selection works in opposite direction to eliminate the bad genes by low viability and low fertility , there is another source for new combinations of genes result from crossing over which may cause new combinations of genotypes .
All genes need suitable environment to express their full phenotype including bad genes ( for example PKU disorder ) , so healthcare can decrease the suffering from some disorders , but this case lead to relax the function of natural selection and result to increase bad gene frequency in the population .