In recent years, increasing attention has been paid to the impact social determinants of health (SDOH) can have on health equity in the United States. In this essay, we provide a framework for considering the upstream structural factors that affect the distribution of SDOH as well as the downstream consequences for individuals and groups. Improving health equity in the United States will require multiple policy streams, each requiring comprehensive data for policy development, implementation, and evaluation. Although much progress has been made in improving these data, there remain considerable gaps and opportunities for improvement. (Am J Public Health. 2023;113(12):1301-1308. https://doi.org/10.2105/AJPH.2023.307423).