The persistence of health inequities has been the focus of policy concern for decades and most recently has been highlighted by the World Health Organization (WHO) Commission on the Social Determinants of Health (CSDH) which concluded that ‘social injustice is killing people on a grand scale’ (2008: 26). This chapter examines why behavioural forms of health promotion are an inadequate strategy for addressing social inequities in health and are unlikely to resolve social differences in risky health behaviour. It then considers why, despite these inadequacies and increasing evidence on the social determinants of health (SDH), behavioural approaches may be appealing to governments and thus come to dominate health promotion policy. The chapter concludes with a discussion of health promotion strategies consistent with addressing the SDH and health inequities, and why these are more likely to improve population health and health behaviour.