Public health have long been leaders in health equity strategy (see Sudbury’s Ten Promising Practices). One key direction has been working with local communities and those marginalized and vulnerable populations facing the most inequitable health outcomes or barriers to services and support. I spoke at an Ontario Public Health Association forum on how to engage with priority populations to identify key service gaps, population needs and levers for change, and to design and deliver the best mixes of programs and resources to enhance the opportunities for good health for all. We spoke of a number of key challenges: how to frame the need to act on underlying social determinants of health in understandable and energizing ways; how to balance coherent overall equity strategies that can connect many specific initiatives with focused programs and investments to improve the health of the worst off fastest; and how to stay grounded in and responsive to diverse community needs and perspectives.