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By many accounts, young people from modest socioeconomic backgrounds who succeed in education and secure gainful employment should expect to experience better physical health as a result of their elevated social position. However, increasing evidence indicates that experiences of socioeconomic mobility may not accompany a health benefit but rather can lead to poorer physical health for some individuals. On certain indicators, adults who originated from disadvantaged backgrounds and achieved educational and economic success found themselves in worse health than their childhood peers who did not experience an upward socioeconomic trajectory. The current article organizes studies from three bodies of research that attempt to describe and explain the health costs of socioeconomic mobility. In addition, a novel framework builds upon the existing studies to articulate a common psychological process, centered on identity and immunology. Underutilized studies of identity provide a deeper understanding of the challenges associated with socioeconomic mobility and their consequences for inflammation and the immune system. The novel framework serves to bridge prior studies of socioeconomic status and health and also provides guidance to inform future studies. Finally, interventions to encourage socioeconomic mobility are considered, with an emphasis on provisions to include elements of social support that may lead to simultaneous positive effects on achievement and physical health.