The relationship between social, family, peer and school factors and leisure engagement within a transactional model of stress and health was investigated in 655 young adults. Results show that the family environment, encouragement from parents and teachers, relationships with peers and socioeconomic factors in childhood predict adult attitudes to and engagement in leisure. In turn, leisure attitude and engagement are related to psychological distress, optimism, perceived control and social support. It is argued that the development of patterns of leisure attitudes and engagement in childhood need to be understood in predicting and changing adult leisure behaviours relevant to health and illness.