RESUMO
Hospitals have the potential to create value beyond the direct clinical care that they provide through tackling the social determinants of health as an 'anchor institution': shifting the way in which they employ staff; procure goods and services; use their physical and environmental resources and assets; and partner with others. However, the societal value of this work is not automatically or accidentally created, it must be intentionally designed and delivered, particularly if it is to tackle inequities. This article proposes five equity principles for healthcare leaders to consider in their hospitals' anchor institution work. There have already been important shifts from the 'traditional way' of conceiving of a hospital's role in the community, but going 'one step further' could help to maximise the equity impact.