Social work practice in health is shaped by underlying paradigms. To effectively target health inequities, practitioners need to consider appropriate paradigms. In this exploration of how six health paradigms shape theory and practice, the two health paradigms that most attended to health inequalities are social determinants of health and political economy. The article undertakes a critical review of the social determinants of health paradigm and the political economy paradigm regarding how they might shape social work theory and practice targeting health inequities.