Stubborn health inequalities deepen for children in Scotland’s poorest communities

New analysis reveals persistent disparities in oral health, obesity, vaccination, and mortality among Scotland’s children, with the poorest communities bearing the heaviest burden and progress stalling in crucial areas.

Children in Scotland’s poorest communities continue to face the worst health outcomes, with new analysis from the Royal College of Paediatrics and Child Health showing stubborn inequalities in oral health, weight, vaccination and early development. The briefing, published alongside the college’s UK-wide State of Child Health 2026 report, says progress across several indicators has stalled or gone backwards, leaving health gaps that are most pronounced in deprived areas and among minority ethnic communities.

The figures paint a worrying picture for Scotland. In 2024, the country recorded the highest child mortality rate of any UK nation, at 10.1 deaths per 100,000 children in the Scottish analysis cited by the report. A separate RCPCH briefing on child mortality places Scotland’s rate at 8.9 per 100,000 in 2024, still the highest in the UK. Whatever the measure, the direction of travel is troubling: the report says the temporary improvement seen during the pandemic did not last, and deaths among children and young people have risen again across the UK.

Oral health remains one of the clearest signs of inequality. The RCPCH says 27% of five-year-olds in Scotland had visible tooth decay in 2024-25, unchanged since 2020. In the most deprived neighbourhoods, 40% of children were affected, compared with 16% in the least deprived areas. The picture is little better for weight: nearly a quarter of four- and five-year-olds were overweight or living with obesity in 2024-25, and children in poorer communities were around twice as likely to be at risk of obesity as those in the wealthiest areas. Vaccination coverage also remains below the 95% target for very few routine childhood immunisations, with uptake markedly lower in deprived communities.

The college says the underlying problem is bigger than any single indicator. Its 2026 report points to persistent gaps in child health data, widening inequality and years of underinvestment in the paediatric workforce. In a statement accompanying the Scotland briefing, Lynn Macleod, the RCPCH officer for Scotland, said too many children were being let down and that the poorest communities were bearing the heaviest burden. She called for sustained investment and a stronger focus on prevention so that every child has a fair chance to grow up healthy and thrive. The college has also urged the Scottish government to back community-based care, expand services closer to home and recognise that reorganising NHS structures alone will not solve long waits or workforce pressures.