Scotland has highest child death rate in UK, doctors find

Scotland has the highest death rate for children of any UK nation, a report by doctors has found.

The Royal College of Paediatrics and Child Health (RCPCH) has warned the country risks raising one of the unhealthiest generations of children unless urgent action is taken.

Analysis by the body has revealed declining or stagnant health for children across Scotland, along with widening inequalities in oral health, obesity and vaccine uptake.

Scotland’s child mortality rate was 10.1 deaths per 100,000 children in 2024 – the highest in Britain.

Meanwhile, more than a quarter (27%) of children recorded noticeable tooth decay in 2024/25, with no improvement since 2020, the report found.

The figure rises significantly for poorer children, with 40% in the most deprived areas showing tooth decay compared to 16% of their richer counterparts.

Nearly one in four (24%) children aged four and five are overweight or obese, with the poorest children twice as likely to be at risk.

The RCPCH said vaccination rates remain a “significant concern”, with few meeting the 95% uptake target, and those from lower income areas experiencing much lower uptake than the average.

The report also showed that children in poorer areas were 14.8 percentage points more likely to have a developmental concern recorded than children living in the least deprived areas at their 27 to 30-month review.

The RCPCH said First Minister John Swinney’s goal of eradicating child poverty must be matched by “decisive action”.

It warned that failure to improve child health now risks lifelong health problems, poorer educational outcomes and entrenched inequalities “long into the future”.

RCPCH officer for Scotland Dr Lynn Macleod said: “This report shows that too many children and young people in Scotland are being let down, with those living in the poorest communities facing the worst health outcomes.

“It is unacceptable that Scotland also has the highest reported child mortality rate among the UK nations. For paediatricians, it is deeply distressing to witness children experiencing preventable declines in their health and wellbeing, particularly in communities facing the greatest levels of poverty and disadvantage.

“These outcomes are not inevitable. That is why we are calling on the Scottish Government to deliver sustained investment and prioritise prevention, so that every child has the opportunity to grow up healthy and thrive.”

Nicola Killean, Children and Young People’s Commissioner Scotland, said: “This report raises concerning failings in upholding children in Scotland’s right to the best possible standard of mental and physical health.

“Children from minority ethnic groups or living in poverty are impacted most, and this is deeply worrying.

“My office shares concerns that mental health services in Scotland are not there when children need them, and too often leave young people without support before reaching crisis point. They must have access to services, care, and treatment appropriate to their age and condition. Without this, their rights to health, development, and life can all be impacted.

“We support calls for improved data collection and transparency, not only to improve care but to enable children to engage with Government action on their rights.

“The Scottish Government must take this report seriously and take action, including through investment in services, to improve children’s right to health.

“We need better data collection to see the true picture and inform effective change. Children should be able to see what progress is – or isn’t – being made.

“There needs to be greater transparency so that the Scottish Government and public authorities can be held accountable.”

Health Secretary Angela Constance said: “I thank the royal college for this report – the death of any child is a tragedy and this report shows why we must embed a preventative approach to improving Scotland’s health and to eradicating child poverty.

“We are taking important steps. Our flagship childsmile programme, for example, provides targeted measures to increase toothbrushing and improve dental health for children across Scotland, with latest statistics showing that 81.5% of P7 pupils now have no obvious tooth decay.

“We are also seeing long waits for planned care appointments and procedures coming down, and activity increasing across NHS Scotland, and I am particularly focused on ensuring children and young people who require treatment get the care they need, when they need it.

“Beyond this, we continue to take action to increase vaccine uptake, invest in mental health support for children and young people, and to reduce obesity, with investments this year in our summer of sport helping get more children physically active.”