When we discuss public health, we instinctively default to the familiar: GP appointments, hospital beds, screening programs, and prescription pads. In our fixation on the systems built to treat disease, we often neglect the conditions that contribute to illness in the first place: loneliness, purposelessness, low confidence, socio-economic standing, unemployment, or workplace anxiety. Conditions that rarely show up in a clinical setting until physical symptoms appear.
This is precisely the void that lifelong learning fills. To that end, we need to stop thinking of learning providers as an add-on to the health system and start recognising them as a pillar of health and wellbeing provision. As we will explore, the data surrounding this argument is no longer merely suggestive, it is incontrovertible.
The problem health services cannot solve alone
The National Health Service treats illness. It does not, by design, treat the causes that create the condition.
The Marmot Review – a landmark 2010 investigation into health inequalities in England – clearly identified that action on health and wellbeing requires action across all of the social determinants: education, occupation, income, community and place.
What the review highlighted, and what a decade of subsequent research has confirmed, is that health is shaped upstream, long before a person arrives in a GP’s waiting room.
In fact, The Marmot Review 10 Years On (2020) found that far from improving, the conditions shaping that downward spiral had worsened. Education funding had declined. Communities had been hollowed out. People with lower levels of education, weaker social networks and fewer opportunities to exercise agency over their own lives were still measurably less healthy, and statistically dying sooner. Rather than improving, the social infrastructure had contracted.
Lifelong learning is a crucial part of addressing that contraction in the capital.
Health & Wellbeing in the workforce
For London’s employers, the psychological wellbeing of their workforce is no longer a background human resources objective. It’s become a front and centre economic concern.
Stress, depression and anxiety accounted for 22.1 million lost working days in the 2024-25 fiscal year.
Health and Safety Executive (HSE)
According to the Health and Safety Executive (HSE), stress, depression and anxiety accounted for 22.1 million lost working days in the 2024-25 fiscal year, eclipsing all other forms of occupational illness. Yet the true toll extends well beyond absenteeism. Strained and disengaged employees silently erode productivity and employee retention, while negatively affecting their organisational culture.
On the flipside, the case for investment is equally clear. Recent research by the Mental Health Foundation identified an average return on investment of around £5 for every £1 spent on mental health interventions in the workplace.
Learning and development sits at the heart of that return. A workforce that feels genuinely invested in – with access to skills development, new thinking and a renewed sense of purpose, is not just more capable. It is measurably healthier. Employers who understand this treat workforce learning as a core business decision, with direct implications for performance, productivity and the bottom line.
Lifelong learning sits at this intersection. It does not just serve individuals who are struggling. It serves organisations that want to sustain the health and capability of the people they depend on.
A generation under strain
The COVID-19 pandemic exposed a fault line that public health policy has been slow to address: young adults aged 18 to 30 have emerged from the past five years among the most affected – and least supported – group in the wellbeing landscape. Studies have highlighted that mental ill-health in this cohort had been rising for two decades, even before COVID struck, and that the pandemic sharply accelerated the trend.
During the first UK lockdown, 18 to 24-year-olds were four to five times more likely to report loneliness than those over 65. A Prince’s Trust survey found that one in four young people felt they would never recover from the pandemic’s emotional impact.
For many, the provision of positive learning opportunities is not simply a route to a qualification or a skill. It is a route back to participation – in work, in community, and in their own sense of capability and worth.
Addressing ageing issues
The challenge does not diminish with age – it changes shape. For older workers approaching retirement, the transition out of employment brings its own risks: loss of structure, purpose, identity and the social connections that work provides.
Research drawing on the English Longitudinal Study of Ageing found that full retirement is associated with declines in both cognitive function and mental health, while those who engage in learning or remain partially active fare significantly better.
For those already in retirement, the evidence is consistent and striking. Studies consistently find that participation in learning programmes is directly attributable to improved psychological wellbeing, even among older adults living with chronic health conditions.
Most people now under 60 can expect to spend a third of their adult lives in retirement, with the number of over-65s projected to double by 2072. How those decades are spent matters enormously to individual health and to the wider demands placed on public services.
Learning provision does not stop being a health intervention when someone turns 60. In many ways, that is when it becomes most important.
Social prescribing: the formal link
The NHS Long Term Plan committed to embedding social prescribing across primary care networks — formally legitimising non-medical, community-based activities alongside medical treatment as part of personalised care.
Lifelong learning providers are not peripheral to that system. They are its heartbeat. In fact, the quality and range of provision across the capital will determine whether social prescribing succeeds or fails.
Upstream intervention
There is a tendency, in public health discourse, to frame learning as a wellness intervention; something that helps people who are already struggling to feel better. That framing is too narrow.
The deeper argument is about prevention, and about where illness originates.
Research consistently estimates that only 10 to 20 percent of modifiable health outcomes are attributable to medical care. The vast majority flow from factors like education, employment, social inclusion, housing and income. Lifelong learning operates in that majority territory. It builds the foundations that make people less likely to need clinical intervention in the first place.
It also addresses the low confidence and lack of agency, that sits underneath many of the visible health challenges faced by Londoners. For many adults, particularly those who left education early or who have spent years in roles that offered little opportunity for growth, the act of returning to learning is itself transformational.
A system that needs recognition
The argument here is not that lifelong learning should replace health services. It is that health services cannot achieve what they need to without it.
The social factors affecting health and wellbeing will not be addressed by more outpatient appointments. They require a parallel infrastructure delivered across all London’s communities. Accessible to all, focused on connection, capability and purpose. A provision that that meets the needs of people long before they are symptomatic.
Across London’s boroughs, lifelong learning providers are actively doing this work. Providing the spaces where social isolation ends, where confidence is rebuilt, where people find purpose and community in the workplace, after retirement, bereavement, unemployment or illness. They are doing it at a fraction of the cost of clinical care, and with outcomes that the evidence increasingly supports.
The question is not whether that work constitutes a public health function. It plainly does. The question is whether we are willing to name it as such, and to resource and protect it accordingly.
