A life-course perspective in social work requires a nuanced conceptualization of how childhood adversity is linked to later-life health, yet this relationship is obscured by cumulative risk counts and fragmented health assessments, which in turn prevents a deeper understanding of specific risks and resilience pathways. Leveraging data from the China Health and Retirement Longitudinal Study, this study examines how different types of adverse childhood experiences (ACEs) relate to health trajectories and the moderating role of family–work arrangements. Using person-centered analyses, we identified three ACE classes—threat-related, deprivation-related, and a low-ACE group—alongside five health trajectories ranging from persistent poor health to minimal impairment. While both threat- and deprivation-related classes predicted adverse trajectories, the threat-related class conferred a unique, elevated risk for gradual health decline and lower cognitive resilience. Family–work arrangements moderated these outcomes, but a single supportive role sometimes offered more protection than managing both, suggesting a potential role strain effect. Critically, findings revealed an adversity-specific buffering pattern: partnership was most protective against threat-related adversity, while employment best buffered against deprivation. In conclusion, the link between childhood adversity and later-life health is enduring, specific, and malleable. This evidence should reshape how social work fosters targeted resilience across the life course.