So-called 'Third Way' responses to inequalities in health have encouraged the 'targeting' of evidence-based interventions at those communities at high risk in order to improve health outcomes. In the UK, one area of persisting inequalities in mortality and morbidity risk is from injury, and there have been recent national and local incentives for relevant agencies to 'address deprivation' in delivering reductions in injury through 'targeting' particular communities in the context of an evidence-based approach to policy making. This case study draws on interviews with those responsible for implementing policy in London in order to explore the tensions inherent in such approaches. We suggest that 'taking deprivation into account' by targeting is unlikely to be a fruitful route for addressing inequalities in health, as it devolves responsibility to a level which has no power to address the determinants of inequality.