I want to tell you what surprised me about this data.
I am building Unwritten Health on the premise that health equity is a data infrastructure problem. I believed that before we had a single survey response. What I did not expect was how clearly 1,204 people would prove it.
In March 2026, 1,204 people from underrepresented UK communities completed the Equity Engine survey. Two numbers dominated the headlines.
82% have felt their health concerns dismissed by a healthcare professional.
83% would be more likely to participate in a clinical trial co-designed with their community.
The finding that stopped me was not the 82%. It was not even the 83%.
It was the graduate confusion rate.
45% of our respondents were told about a clinical trial by a healthcare professional and did not fully understand what they were being told. That number sits at 68% for people with undergraduate degrees. Higher than those with GCSEs. Higher than those with no formal qualifications.
The problem is not literacy. The problem is the language of clinical research itself, which has become so specialised that it excludes the very people it is trying to recruit, including educated professionals who encounter it for the first time.
That finding, more than any other, tells me the industry is not dealing with a trust problem. It is dealing with a design problem. And the design failure runs deeper than most recruitment strategies are built to address.
The other thing that struck me was the geography. 94% of our East of England respondents avoided or delayed seeking healthcare in the last 12 months. The national average is 76%, which is already alarming. The East of England sits 18 points above that, in the region with the fewest clinical trial sites relative to population. The pipeline does not exist for these communities. Not because they do not want to participate. Because the system was not built with them in mind.
This is what The Frequency of Exclusion documents. 1,204 voices. 49 questions. The barriers that are actually stopping people, not the ones the industry has assumed.
The report is free to download and free to share. I would rather it reach the people who can act on it than sit behind a form.
Download it at frequencyofexclusion.com
If you want to talk about what this means for your programme, reply here. I am genuinely interested in those conversations.
Ashish
Founder, Unwritten Health
