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Background Strategies aimed at reducing health inequalities include a focus on improving education, a key determinant of health and labour market outcomes. Studies have demonstrated that both early life socioeconomic disadvantage and child maltreatment result in poorer educational outcomes, but have not examined the effect of the combination of these adversities. Methods This study used de-identified, linked government administrative data from the South Australian Early Childhood Data Project on children born in South Australia who completed Year 5 National Assessment Program—Literacy and Numeracy (NAPLAN) during 2008-2015 (n = 61,445), and their corresponding birth, perinatal, school enrolment and child protection system data. Results Overall, 23.7% (95% CI 23.4-24.1) had a poor NAPLAN outcome (at or below national minimum standard on three or more of the five domains - reading, writing, spelling, grammar and punctuation, numeracy). This proportion was approximately double for children who experienced substantiated maltreatment compared to children who did not experience contact with the child protection system, irrespective of the social circumstances (parental education, employment, housing and area-level disadvantage) in which the child lived. Conclusions Social advantage is not sufficient to protect children from poor educational outcomes if they experience substantiated maltreatment. Interventions and services will need to focus on child maltreatment, in addition to socioeconomic factors, to improve educational outcomes in the population. Key messages Within each social group, from advantaged to disadvantaged children, the risk of poor NAPLAN outcomes was greater for children who had contact with the child protection system.

844Considering child maltreatment in social inequalities of educational achievement: a whole-of-population data linkage study