The PROTECT databank a population based linked administrative resource on child maltreatment and intellectual disability with early findings.

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.