In 2024, around one in four deaths was considered avoidable
Avoidable, preventable and treatable age-standardised mortality rates (ASMRs) in Scotland, 2001-2024
Main Points
- 16,023 deaths were considered avoidable (preventable or treatable) in Scotland in 2024.
- The proportion of deaths which were considered avoidable was 26% (around one in four) in 2024. The figure has been between 26% and 29% for the past fifteen years.
- The avoidable mortality rate in 2024 was 307 deaths per 100,000 population. This is similar to the level in the years immediately before the pandemic.
- There was regional variation within Scotland; the highest rates of avoidable mortality were in Glasgow City and the lowest rates were in East Renfrewshire and East Dunbartonshire.
- There were higher rates of avoidable mortality in more deprived areas The avoidable mortality rate for the most deprived quintile was 4 times as high as the least deprived quintile.
- Avoidable mortality rates among males were 1.6 times as high as among females; the avoidable mortality rates for males were higher compared with females across all SIMD deprivation quintiles.
- The leading causes of avoidable mortality remained cancer and diseases of the circulatory system.
- The leading cause of avoidable mortality remained cancer, despite the rate generally decreasing over time, followed by diseases of the circulatory system. Avoidable mortality due to alcohol and drug related causes fell compared to 2023, to 46 avoidable deaths per 100,000 population.
- Scotland continues to have a higher avoidable mortality rate than both England and Wales.
Avoidable, preventable and treatable mortality in Scotland
Avoidable mortality
Avoidable mortality is defined as deaths that are either preventable or treatable for those aged under 75 years, in line with the international avoidable mortality definition.
Avoidable mortality is defined using the International Classification of Diseases, 10th Revision (ICD-10).
The ICD-10 is the standard diagnostic tool for epidemiology, health management and clinical purposes. It is used to classify diseases and other health problems.
In 2020, the new avoidable mortality definition created by an OECD working group was implemented. The definition was introduced for years 2001 onwards, replacing the two avoidable mortality definitions previously used. Further information on the new definition and its impact on the reporting of avoidable mortality statistics can be found via the ONS Review of the avoidable mortality definition.
Avoidable mortality is defined as deaths that are either preventable or treatable.
A (cause of) death is classified as preventable when it can be mainly avoided through effective public health and primary prevention interventions.
A (cause of) death is classified as treatable when it can be mainly avoided through timely and effective healthcare interventions.
In 2024:
- 26% of all deaths were considered avoidable (16,023 deaths).
- the age-standardised mortality rate was 307.1 (confidence intervals 302.6 to 311.6) deaths per 100,000 people.
The age-standardised mortality rate in 2024 was slightly lower than the rate in the previous year, and is now at a similar to the level seen in the years immediately prior to the pandemic.
Age-standardised mortality rates (ASMRs) are used to allow comparisons between populations that may contain different proportions of people of different ages.
They are a better measure of mortality than numbers of deaths. They account for the population size and age structure and provide more reliable comparisons between groups or over time.
They are calculated using the 2013 European Standard Population (ESP2013) after taking account of changes in the distribution by age of the Scottish population.
More information on the calculation of age-standardised mortality rates is available on our website.
Age-standardised mortality from avoidable causes increased throughout the coronavirus (COVID-19) pandemic from 2019 to 2021, to a high of 345.3 deaths per 100,000 population. The rate has since decreased, to 307 deaths per 100,000 population in 2024. The latest rate is similar to level seen in the years immediately preceding the pandemic.
Figure 1: In 2024 the avoidable mortality rates for females and for males were similar to those before the pandemic.
Avoidable age-standardised mortality (ASMR) rates in Scotland, 2001 to 2024
The avoidable mortality rate for females in 2024 (242 deaths per 100,000 population) was similar to the previous year. The rate for males (377 deaths per 100,000 population) was lower in 2024 compared to 2023. In 2024 the rates for both females and for males were similar to those before the pandemic. Males continue to have a higher rate of avoidable mortality (1.6 times as high in 2024) than females.
Preventable and treatable mortality
There are two types of avoidable mortality: preventable mortality and treatable mortality, which refer to deaths that could be attributed to conditions considered preventable or treatable.
Of the 16,023 avoidable deaths in Scotland in 2024, 10,597 (66.1%) could be attributed to conditions considered preventable and 5,427 (33.9%) could be attributed to conditions considered treatable.
There were 204 preventable deaths per 100,000 population in 2024; similar to the pre-pandemic rate. Preventable deaths (which include deaths due to COVID-19) rose to a recent peak of 243 per 100,000 population in 2021.
There were 104 treatable deaths per 100,000 population in 2024. Over the past decade there have been between 99 and 105 treatable deaths per 100,000 population each year.
Males have consistently higher preventable and treatable mortality rates than females.
Avoidable mortality by Scottish areas
Council areas
The council area with the highest avoidable mortality rate was Glasgow City (439 deaths per 100,000 population) over the period 2022 to 2024.
The lowest rates were in East Renfrewshire (173 deaths per 100,000) and East Dunbartonshire (198 deaths per 100,000).
The rates for Council areas are produced for 3-year periods. Combining the data for multiple years mitigates the effects of year-to-year fluctuations provides a better indication of the overall long-term trend than the figures for the individual years.
Figure 2: Glasgow City was the council area with the highest avoidable mortality rate in the period 2021-2024. East Renfrewshire and East Dunbartonshire had the lowest rates.
Avoidable mortality rates by Council area, all persons, 2021 to 2024 average
Avoidable mortality by deprivation
The Scottish Index of Multiple Deprivation (SIMD) is a measure of how deprived an area is.
SIMD quintiles rank areas of Scotland from 1 (most deprived) to 5 (least deprived).
In 2024, people living in the most deprived quintile in Scotland were four times as likely to die an avoidable death compared to those in the least deprived quintile.
In all SIMD quintiles, the ASMR was higher for males than females, suggesting that regardless of deprivation, males are more at risk of avoidable mortality.
In 2024, the male avoidable ASMR in the most deprived areas of Scotland (quintile 1) was 703 deaths per 100,000 males (confidence intervals 679 to 727). This was 4.1 times higher than the 170 deaths per 100,000 males (confidence intervals 159 to 180) seen in the least deprived areas (quintile 5).
The female ASMRs showed a similar difference between most and least deprived areas, with 449 deaths per 100,000 females (confidence intervals 431 to 468) in the most deprived areas (quintile 1), which was 3.8 times higher than the 118 deaths per 100,000 females (confidence intervals 109 to 126) in the least deprived areas (quintile 5).
Figure 3: In all SIMD quintiles, the avoidable mortality rate was higher for males than females, suggesting that regardless of deprivation, males are more at risk of avoidable mortality.
Avoidable mortality rates by sex and SIMD quintile, 2024
Avoidable mortality rates have generally decreased over the last two decades in all SIMD quintiles, with the exception of during the coronavirus pandemic which saw increased rates in 2020 and 2021.
In 2024, the rate of avoidable mortality in the most deprived quintile was 4.0 times as high as the least deprived. This gap has increased from 2.9 times as high in 2001. The largest difference was in 2021, when the rate in the most deprived quintile was 4.1 times as high as the least deprived.
Figure 4: Avoidable mortality rates in the most deprived areas are four times as high as in the least deprived areas.
Avoidable mortality rates by deprivation, all persons, 2001-2024
Avoidable mortality by cause
In 2024, the leading cause of avoidable deaths was cancer, followed by diseases of the circulatory system.
Cancer has been the leading cause of avoidable deaths since 2008, however the rates for cancer have generally declined. In 2024, the Age Standardised Mortality Rate for cancer was 90 (confidence intervals 88 to 92) avoidable deaths per 100,000 people. The rate was the same as in 2023.
In 2024, the ASMR for diseases of the circulatory system was 82 deaths per 100,000 people (confidence intervals 80 to 84). It is higher than the pre-pandemic rate in 2019.
The next most common group of avoidable deaths were alcohol and drug-related deaths. This group accounted for nearly one in six avoidable deaths in 2024. Avoidable mortality due to alcohol and drug-related causes steadily increased from 35 deaths per 100,000 people in 2013 to a peak of 54 deaths per 100,000 people in 2021. The rate has fallen more recently to 46 deaths per 100,000 people in 2024 (confidence intervals 44 to 48).
Not all causes of death are avoidable
The proportion of deaths that are classified as avoidable varies greatly between ICD-10 chapters. For example, almost all deaths due to external causes are counted as avoidable, whereas under one tenth of deaths due to mental disorders have this classification. See Definitions in the tables for details.
The ICD classification “Provisional assignment of new diseases” contains deaths caused by COVID-19.
COVID-19 was a significant contributor to avoidable mortality in 2020 and in 2021, with an avoidable mortality rate of 28 deaths per 100,000 people in 2020 and 34 deaths per 100,000 in 2021. In 2024 the ASMR for Covid-19 was 3 deaths per 100,000 people (confidence intervals 2.7 to 3.7).
Figure 5: In 2024 the leading cause of avoidable deaths was cancer, followed by diseases of the circulatory system.
Avoidable mortality rates by cause, all persons, 2001-2024
For males the leading cause of avoidable deaths overall, and of treatable deaths were circulatory system diseases, whilst the leading cause of preventable deaths was cancer.
In comparison, for females the leading cause of all avoidable, preventable and treatable deaths was cancer.
For a full summary of all causes of death in Scotland (not only those included in the avoidable mortality definition) please see NRS Vital Events Reference Tables 2024 (Section 6: Deaths - Causes).
Avoidable mortality and cause by SIMD
The leading cause of avoidable mortality was cancer in all quintiles except the second most deprived. The leading cause in the second most deprived quintile was diseases of the circulatory system, although the rate was not statistically different from the rate for cancer.
Since 2001, the avoidable mortality rates for cancer and diseases of the circulatory system have generally been decreasing in the most and the least deprived quintiles. Over the same period, the gap between the most and the least deprived quintiles has been widening.
In 2001, the avoidable mortality rate for diseases of the circulatory system in the most deprived quintile was 2.8 times the rate in the least deprived quintile. In 2024, it was 3.5 times as high.
The avoidable mortality rate for cancer in the most deprived quintile has been at least double that of the least deprived quintile since 2001. The difference has steadily increased from 2.0 to 2.8 times the rate of the least deprived quintile.
Figure 6: In 2024 the leading cause of avoidable deaths in the most quintiles was cancer. In quintile second most deprived quintile it was diseases of the circulatory system.
Avoidable mortality rates by cause and deprivation, all persons, 2001 to 2024.
Avoidable Mortality in Great Britain
Scotland continues to have higher avoidable mortality than both England and Wales.
Figure 7 compares the avoidable mortality rates between Scotland, England, and Wales. In 2024 Scotland (307 deaths per 100,000 people) has a higher avoidable mortality rate than both England (228 deaths per 100,000 people) and Wales (272 deaths per 100,000 people). This continues the trend of Scotland having higher avoidable mortality rates.
Figure 7: Scotland has a higher avoidable mortality rate than both England and Wales. This has been the case since 2001
Avoidable mortality rates in Great Britain, all persons, 2001-2024
In 2024, the leading cause of avoidable mortality in both England and Wales was cancers, the same as in Scotland, followed by diseases of the circulatory system.
In 2024, mortality rates for Scotland were higher than the mortality rates in England for all of the avoidable causes of death. Compared to rates for Wales, mortality rates for Scotland were higher for almost all causes of deaths, with the exception of injuries. Mortality rates for Scotland for the majority of causes of deaths have been higher than those in England and Wales since 2001.
Figure 8: In 2024, the leading cause of avoidable mortality in both England and Wales was cancer, the same than in Scotland, followed by diseases of the circulatory system.
Avoidable mortality rates by cause in Great Britain, 2001 to 2024
Glossary
Age-standardised mortality rates
Age-standardised mortality rates per 100,000 population, standardised to the 2013 European Standard Population. Age-standardised rates allow comparison between populations with different age structures over time.
Avoidable mortality
Deaths which are considered either preventable or treatable for those aged under 75 years, in line with the international definition by the OECD/Eurostat.
For the list of causes of death that are classified as avoidable, please see the “Definition sheet” in our accompanying dataset.
Confidence Intervals
A confidence interval is a measure of the statistical precision of an estimate and shows the range of uncertainty around the estimated figure.
They are based on the lower and upper 95% confidence limits for the age-standardised mortality rates.
As a general rule, if the confidence interval around one figure overlaps with the interval around another, we cannot say with certainty that the difference between figures is statistically significant.
Preventable mortality
Causes of death that can be mainly avoided through effective public health and primary prevention interventions
Scottish Index of Multiple Deprivation (SIMD)
The Scottish Index of Multiple Deprivation is a measure of how deprived an area is.
If an area is identified as ‘deprived’, this can relate to people having a low income but it can also mean fewer resources or opportunities.
A score is given to all of Scotland’s data zones based on multiple indicators of deprivation. The data zones are then ranked 1 to 6,976 based on their score. Subsequently, the rankings are split into 5 equally sized groups forming SIMD quintiles.
Statistical significance
Refers to statistically significant changes or differences. Statistical significance has been determined using the 95% confidence intervals, where instances of non-overlapping confidence intervals between figures indicate the difference is unlikely to have arisen from random fluctuation.
Treatable mortality
Causes of death that can be mainly avoided through timely and effective healthcare interventions, including secondary prevention and treatment.
Methodology
NRS uses the OECD international definition of avoidable mortality to ensure our statistics are comparable internationally and with other parts of the UK.
This definition has been applied to the full time series back to 2001.
Deaths are classified as preventable or treatable according to their cause of death and the age at death.
More information on the quality and methodology can be found on the ONS website.
Strengths and Limitations
Strengths
- Information is supplied when a death is registered, giving complete coverage of the population and ensures highly accurate estimates that are representative of the population.
- Coding for cause of death is carried out according to the World Health Organization (WHO) ICD-10 framework.
- The use of age-standardised mortality rates means our statistics are comparable between local health boards, councils and at national level.
- The use of the OECD definition also makes the statistics in this report comparable internationally.
Limitations
- Data are insufficiently robust to provide local authority estimates for smaller areas for single years (hence why they are aggregated over a 3-year period). This limits the timeliness of the data.
- In a small number of cause of death categories, the number of deaths was too small to report a reliable rate. For this reason, the categories were combined and thus limits the precision accuracy of our cause of death reporting.
- When the number of deaths was too small to report a reliable rate, (10 or less deaths), only the number of deaths were reported.
Information about our statistics
These statistics are designated as Accredited Official Statistics. More information about Official Statistics can be found on the Statistics governance and consultation page.
We also provide information about upcoming publications on our website.
If you would like receive updates on our statistics, you can register your interest on the Scottish Government ScotStat website.
