Do you know which conditions are directly impacting a individuals to have health equity?  SDOH Software should enable you to track specific needs that a person has and work with your local community partners to enable them to get the help they need.  This could include transportation assistance, language skills, food quality etc.  Tracking this information will allow you to compare claims and current health outcomes and then monitor their SDOH conditions to see how their health outcomes improve once you have identified their need and helped them get assistance.  Health equity can only be changed by improving the ability of a member to make better choices, access better services or healthy living conditions.