This article examines the multi-dimensional health inequities that Dalit women in India experience, employing the Social Determinants of Health (SDH) framework to unpack the caste-gap in morbidity and mortality. Rooted in the concept of ‘biological weathering,’ this review examines how structural violence and ritualised exclusion are converted into physiological breakdown, yielding a staggering 14.6-year survival gap relative to dominant-caste women. Through the integration of longitudinal data from the National Family Health Survey (NFHS-5) and institutional documents, this research reveals a triple burden of caste, gender, and class that is expressed through chronic energy deficiency, severe anaemia (56.7%), and high rates of under-five mortality (56.4 per 1,000 live births). This review emphasises the ‘Paradox of Institutional Delivery,’ suggesting that improved hospital access is compromised by institutionalised obstetric violence and a clinical gaze that otherizes marginalised bodies. Additionally, the caste-nutrition nexus and occupational pathologies related to dangerous labour, such as manual scavenging and landless agricultural labour, accelerate cellular ageing. The article concludes that the public health structure in India needs to shift from a caste-blind strategy to a caste-sensitive framework. This needs to be achieved by bringing together anti-discriminatory healthcare practices, land rights-based nutritional security, and trauma-informed mental health services to fill the biological divide created by social inequality.