Pervasive, lifelong inequalities in physical health begin in early childhood and are driven, in part, by social gradients in risk factors such as smoking and obesity. Yet not all low-income children have elevated physical-health risks as adults. The relation between income-to-needs ratio at age 9 and smoking prevalence and body fat (body mass index) at age 17 was examined in a sample of 196 rural adolescents. Income-to-needs ratio is the U.S. federal government's defined index of household income as a proportion of the poverty line. This is the first study to show that links between childhood poverty and subsequent physical-health outcomes can be loosened. At-risk youth in communities with a relatively rich array of social capital did not smoke more or have greater excess body fat compared with their more affluent counterparts.