In a sector historically hampered by fragmentation and underinvestment, we stand at an inflection point with increased federal attention and funding flowing into health equity. With current incentive models, we’re seeing massive privatization of the data, the networks and pathways to services in the Social Determinants of Health (SDOH) sector. This reality creates cycles of disempowerment for communities and profit hoarding for the private sector, while leaving the root causes of social needs to manifest. We’re proposing a radical vision for an open, public infrastructure to support equitable outcomes in the Social Determinants of Health sector, including a transformative approach that integrates all stakeholders in the journey towards health equity.