This study examined whether the accumulation of physical, psychosocial, and combined health adversities measured when children were aged 8 to 9 years predicts worsening of academic scores at 8 to 9 and later when children are aged 10 to 11 years. At 8-9 years of age 24% had one physical health adversity, 10% had 2, and 5% had three or more physical health adversities, while 27%, 10% and 5% had 1, 2, or 3 or more psychosocial health adversities. The accumulation of health adversities predicted poorer academic achievement up to two years later. For each additional health adversity children had at 8-9 years, their academic scores fell incrementally, both at 8-9 years, and two years later when children were aged 10-11 years. The number of adversities children experienced was more important than the type of adversity (physical or psychosocial). The authors suggested interventions need to address multiple domains to improve children's academic outcomes and be delivered across the health-education interface.