University of Southern California:: Health + Social

For most of modern medical history, health has been understood primarily through a biomedical lens.

A patient becomes ill.

A provider diagnoses the problem.

A treatment is prescribed.

The system works to restore health.

Yet decades of research have revealed a more complicated reality.

The factors most likely to determine a person's health often exist long before they enter a hospital or clinic.

Where they live.

Whether they have stable housing.

The quality of their education.

Their access to healthy food.

Their relationships.

Their income.

Their neighborhood.

Their opportunities.

Collectively known as the social determinants of health, these forces shape health outcomes as profoundly—and often more profoundly—than biology alone.

Today, this understanding is widely accepted.

The challenge is that healthcare systems and healthcare education have struggled to keep pace.

While providers increasingly recognize the influence of social factors, many remain insufficiently prepared to address them in meaningful ways. Clinical training continues to focus primarily on acute biomedical problems, even though many of the conditions affecting patients originate in social environments rather than examination rooms.

Working as Innovators-in-Residence at the USC Suzanne Dworak-Peck School of Social Work, GREEN::HOUSE helped explore what healthcare education might look like if social determinants were treated not as peripheral concerns, but as central drivers of health.

The effort contributed to the development of USC's groundbreaking graduate nursing program—the first nursing program in the nation housed within a school of social work.

This was more than an organizational distinction.

It represented a fundamentally different way of thinking about health.

Rather than separating medical care from social realities, the program sought to integrate them.

To support this work, GREEN::HOUSE developed Health + Social, a publication examining the implications of social determinants for healthcare delivery, professional education and the future of nursing.

The publication brought together leading voices from healthcare, social work and related fields to explore a critical question::

What would healthcare look like if we designed it around the conditions that create health rather than simply the conditions that undermine it?

The work highlighted a growing disconnect between what we know and what we do.

As our editor observed::

"The basic reason for the neglect of social determinants in healthcare is that the system is primarily set up to treat acute, biomedical problems. Substantial work remains if we hope to translate our understanding of social determinants into practical, specific protocols for care on the individual or community level."

The challenge was not awareness.

It was implementation.

How should providers assess social factors?

How should care teams respond?

How should healthcare organizations engage communities?

How should future nurses and clinicians be trained?

These questions helped shape both the publication and the emerging nursing program.

Former Dean Marilyn Flynn captured the significance of the opportunity in the publication's foreword::

"Conditions of poverty, injustice and broken human relationships provide the etiology for gunshot wounds, delayed development, late-stage diagnosis and lack of access to care. Our experts here note that nursing may have more potential than other health professions in bringing power and authority to the idea of social determinants and incorporating this content into training and professional perspectives."

GREEN::HOUSE remained involved from the program's inception through the enrollment of its inaugural cohort and beyond, helping explore how social determinants might inform not only nursing practice but also new research agendas, doctoral education models and approaches to healthcare innovation.

Many of the questions explored through Health + Social have since become central to healthcare strategy nationwide.

Health equity.

Community health.

Whole-person care.

Behavioral health integration.

Population health management.

The future of healthcare increasingly depends on understanding the relationship between social conditions and clinical outcomes.

For GREEN::HOUSE, the project reinforced a belief that continues to guide our work:

Health is not created solely in hospitals.

It is created in homes, schools, workplaces, neighborhoods and relationships.

And if healthcare professionals hope to improve health outcomes, they must be prepared to understand—and engage with—the realities that shape people's lives long before they become patients.

Because the future of healthcare is not merely medical.

It is profoundly social. ::