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Building on calls within the health literature for a deeper engagement with the concept of agency, we utilize nationally representative survey data from the National Longitudinal Study of Adolescent to Adult Health (N = 13,592) to develop an empirical conception of the traditional treatment of health agency focused on two social psychological constructs that build upon current foci on personal control within the stress process model: (1) "subjective vitality" and (2) a forward-looking orientation ("optimism"). We find an interesting paradox: adolescents with higher health-based agency early in the transition to adulthood have significantly higher status attainment (occupational and educational) outcomes, but early mental health advantages disappear over the transition to adulthood. This suggests that while subjective beliefs about health agency put adolescents on trajectories toward higher socioeconomic status, they also set them up for declines in mental health due to unachieved expectations. There seem to be objective upsides and subjective downsides of possessing greater agency in adolescence.