Youth participation in public health: from presence to power

Across Europe, the need to strengthen social participation is increasingly recognised as a core component of public health governance.The recent WHO Resolution on Social Participation for Universal Health Coverage (WHA77, 2024) formalises this shift, urging health systems to establish sustained, structured, and accountable mechanisms enabling communities to influence decisions.Yet one group remains inadequately engaged despite being profoundly affected by today's health challenges: young people.Participation as a governance function, not a gesture Classic theories such as Arnstein's 'Ladder of Citizen Participation' highlight the distinction between symbolic inclusion and shared decision-making.Much youth engagement still sits in the lower rungs of this ladder.Feedback is collected, but impact on the policy cycle remains minimal.Meaningful participation requires investment in public-sector capacity, clarity of purpose, and stable institutional architecture.These requirements apply even more strongly when engaging adolescents and early-career professionals, whose presence is often welcomed but rarely supported through formal governance pathways.