This article explores the differing health status of lower caste social groups in India, analyses the reasons for the differences and discusses some of the implications for policy. National Family Planning and Health Survey (NFH‐3) data shows that children belonging to lower castes have worse nutrition, health and mortality indicators and poorer access to health services and nutrition schemes than children from higher castes, even after other socioeconomic factors are considered. The article suggests that this points towards the possible role of discrimination and exclusion associated with caste and ‘untouchability’ and outlines some policy recommendations that are proactively inclusive, specifically in the nutrition domain.