Children in deprived areas of Scotland are three times more likely to die before their first birthday

It’s 2025 and we’re already a quarter of the way through the 21^st century. It should be unthinkable that a child’s health and future are still so heavily dictated by their postcode. And yet, here we are. We’re still talking about tackling childhood health inequalities in Scotland as though it’s a new problem. It’s not. It’s a long-standing injustice which should have been confined to the history books years ago.

Earlier this year, the Royal Society of Edinburgh and the Mental Health Foundation brought together more than 40 experts from across Scotland to examine this very issue. The findings from that national workshop were as stark as they were familiar: children in our most deprived communities are still facing significantly worse physical and mental health outcomes than their more affluent peers.

Let’s be clear about what that means in real terms. A child in a deprived area is 6.5 times more likely to have experienced multiple adverse childhood experiences by age eight, and 2.9 times more likely to struggle with emotional and behavioural issues by age three.

Read more:

• Brain disease linked to boxers and American football players found in homeless people
• Cost of housing homeless people in temporary accommodation soars to £2.8bn
• I couldn’t afford to fix my broken bed. People in poverty like me need help with the essentials

They are 10 times more likely to be exposed to tobacco smoke in the womb, three times more likely to have developmental concerns, twice as likely to be obese by school entry.

And alarmingly, they are three times more likely to die before their first birthday.

These are not just statistics. Our children are suffering and it’s entirely preventable. These figures are a damning indictment of Scotland’s collective failure to act decisively and compassionately.

The workshop didn’t uncover anything we didn’t already know. The barriers to progress are depressingly familiar: a disconnect between research, policy, and practice; a lack of meaningful involvement of the communities most affected; and data systems that fail to capture the full picture. Add to that chronic underfunding of public services and the third sector, and it’s no wonder we’re still stuck.

What’s most frustrating is that we do know what works. We know that prevention is more effective than crisis response. We know that policies designed with communities, not just for them, are more likely to succeed. We know that stable funding, better data, and a focus on equity can transform outcomes.

So why aren’t we doing it? The truth is childhood health inequalities are not inevitable. They are the result of political choices about where we invest, who we listen to, and what we prioritise. To truly address childhood health inequalities, we must go beyond acknowledging the problem, we need to stop tinkering around the edges and fix the systems that perpetuate it.

The workshop identified critical gaps not only between research and policy, but also within academic research itself and in the practical delivery of national initiatives at the local level. These gaps reflect deeper issues of coordination, inclusion, and data quality.

Children and families must be at the heart of policy design. That means embedding co-design as standard practice, not a nice-to-have. Diverse lived experiences should inform every stage of policy development, especially for communities most affected by inequality. We also need to strengthen the evidence base by investing in research that explores structural and societal root cause of poor health, like poverty, housing, and employment.

Policy frameworks like Getting It Right for Every Child (GIRFEC) offer strong foundations, but they must be implemented consistently and strategically. Community-based initiatives need long-term support, not short-term funding cycles and bureaucratic hurdles. We must shift decisively toward preventative approaches, with better alignment between national strategy and local delivery.

In short: we know what needs to change. The question is whether we’re willing to do it and whether we’ll still be having this same conversation in another five years.

Read the full Report on National Workshop into Childhood Inequalities.

Julie Cameron is associate director at Mental Health Foundation and an alumni of the RSE Young Academy of Scotland. Find more information on Mental Health Foundation here and on the Royal Society of Edinburgh here.

Do you have a story to tell or opinions to share about this? Get in touch and tell us more. 

Reader-funded since 1991 – Big Issue brings you trustworthy journalism that drives real change.

Every day, our journalists dig deeper, speaking up for those society overlooks.

Could you help us keep doing this vital work? Support our journalism from £5 a month.