Despite making up around 8 % of England’s population, adults aged 18-24 account for only about 4.4 % of participants in studies backed by the National Institute for Health and Care Research (NIHR) research delivery network — highlighting a serious case of low youth participation in medical research.
Between April 2021 and March 2024 some 32,879 people aged 18-24 took part in 5,042 NIHR-backed studies, equating to roughly seven young participants per study.
Why this matters
Young adults may generally face fewer immediate life-threatening conditions than older populations, but the burden of long-term physical and mental health issues is high: nearly 45 % of those aged 24 or under report a long-term condition.
When treatment and intervention design rely overwhelmingly on older adult cohorts, younger people risk receiving therapies that are less effective, less safe or simply not tailored to their unique needs. As Kirsty Blenkins of Association for Young People’s Health emphasises, this represents “a distinct set of health challenges … shaped by major life-transitions, social pressures and inequalities” which are often overlooked in research.
Barriers to participation
Experts identify multiple reasons for the low youth representation:
•Limited awareness of research opportunities among young adults.
•Recruitment processes and study cultures that are not designed with young adults in mind — e.g., inconvenient schedules, lack of youth-friendly outreach.
•Using research materials, consent processes or study settings that may feel inaccessible or irrelevant to younger participants.
•Concerns over confidentiality, mistrust of research systems, or belief that studies are only for “older” or “sick” populations.
Recent developments and efforts to close the gap
In June 2025 the UK government announced an “unprecedented boost” for clinical trials as part of its 10-Year Health Plan, aimed at increasing participation — especially among under-represented groups including young people — via the NHS App and the Be Part of Research service.
Under this plan:
•The NHS App will match people with studies based on health data and interests.
•Trial set-up times are to be cut from ~250 days to ~150 by March 2026, to make trials easier to access.
•The campaign is explicitly encouraging younger adults, ethnic minorities and other underserved groups to register.
Risks if nothing changes
Unless participation rises, there are real-world consequences:
•Treatments may lack evidence for younger age groups, meaning effectiveness and safety remain untested for many.
•Health inequalities may widen — young people from disadvantaged backgrounds or minority groups may be further excluded.
•Trust and engagement in healthcare systems may erode among younger cohorts if they feel ignored by research and innovation frameworks.
What could improve youth engagement
Experts suggest the following strategies to tackle low youth participation in medical research:
•Design studies with youth involvement from the outset — engaging young people in planning and recruitment.
•Use targeted, youth-friendly outreach via social media, apps or community settings rather than generic adult-oriented channels.
•Simplify consent and information materials — make research opportunities visible, accessible and relevant to 18-24s.
•Offer flexible scheduling or remote participation options to accommodate younger adults with work, study or family commitments.
•Embed youth engagement as standard practice in research culture, not as an afterthought. As Dr Esther Mukuka (NIHR) states, “scientific discovery is moving further and faster than ever… treatments of tomorrow will be very different from what we understand today”.
