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This study examines the role of health as it may contribute to racial disparities in post-prison achievement of the traditional markers of adulthood (i.e., residential stability, education, and formal employment) for young adult parolees undergoing the transition to adulthood. In research on the transition to adulthood, the health domain has generally been overlooked, possibly because most young adults have few health risk factors. Yet critical health-related threats to successful adult transitions are evident in public health statistics: the leading cause of death among young black males is violence (i.e., homicide). Among young white males, the leading cause of death is unintentional injury, of which drug overdose is the second most common. Interrelationships between the traditional transition to adulthood domains (education, work, family) and the domain of health, as measured by substance abuse and ongoing interactions with the criminal justice system for violent offenses, are explored via multiple causal modeling strategies. Implications for the transition to adulthood framework as it relates to at-risk youth undergoing the transition to adulthood are discussed.