Scholars have documented the lasting impact of childhood socioeconomic status (SES) on health, but few studies have considered how state contexts in childhood shape health trajectories based on childhood SES across the life course. The current project uses data from the Panel Study of Income Dynamics, 2009-2021 (N = 18,227 person-year observations of adults aged 18-41) to build on these studies by 1) examining state variation in the relationship between childhood SES and adult self-rated health, and 2) assessing the contributions of childhood state-level economic context in moderating this relationship. Logistic regression models first confirmed the expected relationship between childhood SES and adult self-rated health that parallels other literature (OR = 1.79, 95% CI 1.46, 2.19). Of the 37 states included in the analysis, there was a statistically significant difference in reporting poor health between low and high-childhood SES groups in 14 states. The interaction between childhood SES and state-level income inequality (OR = .01, 95% CI -9.77, -.62), suggests that exposure to higher levels of income inequality in childhood was more harmful for the health of individuals from higher SES backgrounds. The interaction between childhood SES and unemployment rates (OR = 1.13, 95% CI 1.03, 1.24), suggests that exposure to higher unemployment rates in childhood was more harmful for the health of individuals from lower SES backgrounds. This study finds important state-variation in the relationship between childhood SES and adult health and identifies income inequality and unemployment rates as factors in these differences.