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The PROTECT databank a population based linked administrative resource on child maltreatment and intellectual
S Abou Chabake1,2, J Dion3,4, I Daigneault5,6
1Group for Research and Intervention on Children's Social Adjustment (GRISE), Université de Sherbrooke, 2500 Boulevard de l'Université, room A7-363, Sherbrooke, J1K 2R1, Québec, Canada.
Insights
Children with intellectual disability (ID) and maltreatment face the highest health service use. Intellectual disability was the main factor linked to increased health burdens, especially mental health needs.
Area of Science:
- Child Health
- Public Health
- Developmental Disabilities
Background:
- Children with intellectual disability (ID) face significant social and health challenges.
- Limited population-level data exists integrating child protection and healthcare information for this group.
Purpose of the Study:
- To introduce the PROTECT databank, a linked administrative data resource in Québec, Canada.
- To examine the cumulative burden of health service use in children with ID and/or maltreatment.
Main Methods:
- A retrospective longitudinal cohort study of 18,095 children born between 2001-2016.
- Linked data from child protection, physician billing, and hospitalization records.
- Compared four cohorts: ID only, maltreatment only, both, or neither.
Main Results:
- Children with co-occurring ID and maltreatment had the highest cumulative service use.
- Intellectual disability was the primary correlate of elevated service use across all outcomes.
- The highest mental health service burden was observed in children with both ID and maltreatment.
Conclusions:
- The PROTECT databank is a valuable resource for studying developmental and protection risks.
- Findings highlight significant health inequities for children with ID and maltreatment.
- Actionable evidence is provided to reduce health disparities for vulnerable children.
Abstract:
Children with intellectual disability (ID) experience disproportionate social and health adversities; however, population-level evidence integrating child protection and healthcare data remains scarce. We introduce the Child Development and Protection Pathways in Intellectual Disability (PROTECT) databank a province-wide linked administrative infrastructure in Québec, Canada, and report initial findings from a population-based retrospective longitudinal cohort study (N = 18,095). Using linked child protection records, physician billing claims, and hospitalization data, we identified children born between 2001 and 2016 and residing in six administrative regions. ID was defined using outpatient and inpatient diagnostic codes, and maltreatment was defined as at least one child protection report retained for evaluation before age 18. Children were classified into four mutually exclusive cohorts based on the presence or absence of ID and child maltreatment. We estimated the prevalence and cumulative burden of mental and physical health service use and compared cohorts using negative binomial regression models. Children with co-occurring ID and maltreatment experienced the highest cumulative burden of service use, whereas those with neither exposure had the lowest. Across outcomes, the presence of ID was the primary correlate of elevated burden, with the highest mental health burden among children with dual exposure. PROTECT establishes a scalable population-level resource to examine intersecting developmental and protection-related risks and provides actionable evidence to inform strategies aimed at reducing health inequities among children with developmental vulnerabilities.
