BACKGROUND: In the United States, significant disparities exist in preventative health among underserved communities, including African American/Black (AA/B), Hispanic/Latino (H/L) and lesbian/gay/bisexual/transgender/ queer (LGBTQ+) individuals. We explored the influence of social determinants of health (SDOH) on preventative health outcomes in these groups. METHODS: We conducted a comprehensive cross-sectional needs assessment at safety-net health clinics in Providence, Rhode Island, from June to September 2022. RESULTS: Of N=1,017 individuals, 67% identified as H/L, 16% identified as AA/B, and 19% identified as LGBTQ+. The most common diagnosed health conditions were anxiety (26%), depression (23%), hypertension (20%), and diabetes (15%). People reported most commonly needing help with food (31%), housing (25%), and utilities (22%). More social needs were associated with reductions in COVID-19 booster vaccination (p<.01) and higher mental health diagnoses (p<.01). AA/B individuals with higher health literacy were also less likely to be diagnosed with a mental health condition (p=.02). LGBTQ+ individuals were more likely to report a history of mental health illness, tobacco use, hazardous alcohol use, other substance use, and more sexual partners (p<.05). CONCLUSIONS: Addressing health literacy and other social determinants of health is important to address disparities and achieve health equity among marginalized communities.