Rising income inequality and pessimism about the current and future status of race relations in the United States make this both a challenging time for the pursuit of health equity and also an important opportunity for action. We glean lessons from past and ongoing philanthropic investments in health equity and recommend approaches that can guide future work by foundations. Improving health equity is a complex process that must take into account a variety of factors that affect health, of which access to high-quality health care is just one element. Accordingly, improving health equity will require the combined forces of philanthropy, the public sector, and sectors that have not traditionally been identified with health.