Can capitalism drive health equity? Considering the benefits and risks of social drivers of health bonds

Capitalism and health are not synonymous. Numerous health care advances and innovations have stemmed from the financial incentives that a capitalistic society fosters, but individuals and communities achieving optimal health is not always tied to a financial gain. The impact of capitalism-derived financial tools such as social bonds to address social drivers of health (SDH) therefore needs to be carefully scrutinized, not only for the potential benefits but also for the potential unintended consequences. Ensuring that as much of the social investment as possible is directed by communities experiencing gaps in health and opportunity will be crucial. Ultimately, failure to find ways to share both the health and financial benefits of SDH bonds or other market-derived interventions risks perpetuating underlying wealth inequities between communities and deepening the structural issues that cause SDH disparities in the first place.