Making the connection: Health and adult education

The third Global Report on Adult Learning and Education (GRALE 3), published by the UNESCO Institute for Lifelong Learning in 2016, highlighted the impact of education on health and wellbeing and urged policymakers to strengthen the links between education and health. Adult education, in particular, it reported, had a demonstrable positive impact on:

  • general health, reducing absenteeism at work and in education and enabling people to better fulfil their family and community responsibilities;
  • behaviours and attitudes (e.g. reductions in alcohol consumption and smoking and increased sexual health awareness), stimulating greater personal responsibility for health;
  • life expectancy and an extended period of life without limiting disabilities; and
  • mental health, lowering rates of depression and promoting better coping strategies and greater life satisfaction.

Self-esteem and self-efficacy are other important outcomes of learning, relevant to improved mental health and wellbeing in particular, as highlighted by Cathie Hammond in The wider benefits of Learning: The impact of education on health, family life and social capital (Schuller, Preston, Hammond, Brassett-Grundy and Bynner, 2004). Hammond also reminds us that education and wellbeing need not always have a positive impact on self-esteem and self-efficacy, for example if a student’s experience raises expectations that cannot be met or reinforces negative self-impressions. Nevertheless, the picture overall is an overwhelmingly positive one.

At a societal level, these individual benefits result in increased human capital and more active citizens, a reduction in healthcare costs due to increased use of outpatient care and a decreased use of inpatient care, and a more active, productive, self-reliant population. The benefits are well-evidenced (through the work of the Centre for Research on the Wider Benefits of Learning, for example), yet, in practice, while most countries say they recognise the benefits of adult education to health, few do much to support or promote these benefits, and effective coordination between health and education budgets is rare.

It is increasingly obvious that this needs to change. The cost of healthcare has been a hotly debated topic in the UK in recent weeks, for example, with many questioning whether the NHS funding model is broken and universal, fee healthcare no longer affordable. However, the problems facing the NHS are not unique to the UK’s healthcare funding model. They are typical of all countries where populations are ageing (and, in fact, far from being broken, the direct taxation model remains, according to the King’s Fund, among the most efficient ways to fund healthcare). Nevertheless, with costs rising steeply, something has to give, and endlessly increasing investment in treating illness is not much of a blueprint for the future. With people living and working longer, it is crucially important that countries find ways to coordinate their policies on health, mental health and education, especially adult education.

As GRALE 3 shows, even small investments in education can have large returns for health. Yet in many countries – and certainly in the UK – investment in adult education has been declining. Adult learning is often squeezed out when education budgets are cut and the tendency of policymakers to work in silos makes it difficult to make a persuasive case for using a portion of health spending, however small, to fund adult education. Equally, it is a challenge to convince employers that it is worthwhile investing in staff development opportunities that are not directly related to job performance. Employers are understandably reluctant to invest in something that seems to be of no direct benefit to them and tend to regard it as an unaffordable luxury, but, in fact, organisations such as MerseyTravel and Arriva in the UK, which have adopted such policies, often in collaboration with unions, report real benefits in terms of staff morale, loyalty, retention, absenteeism and the culture of the organisation. Ford’s new campaign to raise mental health awareness in the workplace is another example of a company recognising that worker health is not a peripheral concern but something employers must take seriously and invest in.

One of Sir Alan Tuckett’s innovations as Director of the National Institute of Adult Continuing Education was to introduce a scheme to fund the small-scale learning of all staff – the one condition was that the learning had to have absolutely nothing to do with their day jobs. This was a brilliant idea, which led people in all sorts of different directions – I recall one colleague taking a butchery course, while another took ukulele lessons (later touring with a band). But what was interesting, I think, was the impact this had on people’s sense of wellbeing at work, their feeling of belonging and the intellectual culture of the place. This kind of ‘seriously useless learning’, to borrow Alan’s phrase, can give people a start in a new career, help them cope with depression and other difficulties, improve their self-esteem and confidence (and consequently their relationships with others), reacquaint them with learning after a lengthy absence, and ignite a real passion for learning. And, of course, these benefits ripple out, into people’s families and communities. The scheme was a great example of an organisation living the kind of change it wanted to see in wider society.

Even in times of severe financial constraint, the case for investment in adult education as a means of reducing health costs and supporting the health and wellbeing of populations is strong. However, as GRALE 3 makes clear, it is not only a matter of investment and, in fact, relatively modest increases in spending can have a huge impact here. Equally significant is the coherence of policy-making and the coordination between sectors. Yet, in too many cases, compartmentalisation and poor interdepartmental collaboration limit the positive impact of education on health and wellbeing. Only 20 per cent of respondents to the GRALE 3 survey felt collaboration between health agencies and adult education providers was effective. The 2030 Agenda for Sustainable Development is, in effect, an invitation to this sort of collaboration, as GRALE 3 points out. Its 17 goals are ‘inseparable’, which is to say they cannot be achieved singly but only through considered attention to all and the way in which they interact. It demands that areas usually kept apart in policymaking are brought together and encouraged to talk. There is something here on which policymakers can build.

The truth though is that none of this will happen without far more engagement and proactivity from the wider public, to whom the goals of the 2030 Agenda are largely unknown. Disparities in engagement reflect deeply entrenched inequalities in education and health, which, of course, compound each other. Another key finding of the Centre for Research on the Wider Benefits of Learning was that engagement in adult education courses predicted greater levels of civic and political participation. Countries serious about addressing these inequalities will already be investing in the lifelong and lifewide learning of their citizens, recognising that without intervention the benefits of education for health will tend to coalesce among those who have already benefited the most. The societal and economic benefits are considerable but many countries, I fear, will consider an increase in civic participation to be a cost rather than a benefit. Nevertheless, the cultivation of a culture of lifelong learning is probably the most constructive thing any country struggling with the rising costs associated with an ageing population can do, and it is arguably a precondition for achievement of the 17 Sustainable Development Goals. Certainly, those goals will not be met without the civic and political engagement of citizens.

Some countries are already moving along this road. Others, such as the UK, seem to be moving backwards. The failure to invest in the skills, talents, aspirations and creativity of everyone in society, at every stage of their lives, looks increasingly wrong-headed, given the challenges we now face. Countries need healthy, active, resilient and flexible lifelong learners who are able to adapt and retrain throughout life if they are to be competitive, productive and successful. And people need and deserve the opportunity to realise all they can be, whoever and wherever they are, as a matter of social justice. After a decade or so when many governments, the UK included, have substantially reduced investment in the learning of adults, despite the increased acceptance of the wider benefits of lifelong learning, maybe it is time to change course.

Advertisements

The ‘left behind’ need hope not hollow words

Yesterday, on Easter Sunday, UK Prime Minster Theresa May gave her Easter message, describing the inspiration she took from her faith and the praising ‘the triumph of the human spirit’ in overcoming serious adversity such as that presented by the Grenfell Tower fire. The short address was replayed throughout the day by the BBC with a soft-spoken reverence usually reserved for occasions of state, juxtaposed with in-depth coverage of the Sunday Times fishing trip to identify supporters of Opposition leader Jeremy Corbyn who have made anti-Semitic comments online.

Mrs May’s message ticked many of the usual boxes. Acknowledgement of the country’s ‘dark moments’? Check. Praise for the emergency services? Check. Admiration for ordinary people working to make their communities better? Check. But for those working at the front line of our emergency services, struggling to meet increased demands with reduced funding, or those working hard in their communities to ameliorate the harm done by years of political neglect and austerity, I suspect these sentiments will have provoked derisive laughter rather than delight at having their work recognised. The association of these sentiments with a belief system founded by a man who dedicated his short life to helping the poor and vulnerable and to encouraging the rich to do the same was just another pointed irony in an Easter message that was as hollow as an Easter egg.

The mismatch between the Prime Minister’s supposed core beliefs and the policies of the governments in which she has been a senior figure was thrown into still sharper relief today. A report from school leaders painted a shocking picture of destitute school children in poor parts of England and Wales and ‘filling their pockets’ with food from the school canteen. Headteachers told how they were having to provide basic services such as washing school uniforms and paying for budget advice for parents to fill the gaps left by budget cuts to councils and social services. They also described how they had provided sanitary products for pupils and bought them coats and shoes in winter.

At the same time, a new survey from the Child Poverty Action Group and the National Education Union found that, of 900 teachers, 60 per cent said that child poverty in their schools had worsened since 2015, with one in three saying it had got significantly worse. All this at a moment when school costs are increasing and the government has reduced school funding in real terms.

Theresa May’s launched her premiership in 2016 by pledging to help the ‘left behind’ and ‘just managing’ and build a fairer Britain. A little over a year in, the Social Mobility and Child Poverty Commission resigned en masse in protest at her government’s failure to address Britain’s ‘burning injustices’. May’s failure to appoint a replacement has, reportedly, had little to do with the availability of appropriate candidates and everything to do with an inability to find anyone who would consent to do the job while refraining from criticism of the government’s policies.

This is not particularly surprising. May’s flagship policy for improving the life chances of the poor was to increase selection in schools through the introduction of more grammar schools. Few, other than a handful of Tory ideologues, were convinced by this intervention, perhaps because of the complete lack of supporting evidence for it. The evidential gap was further highlighted last month through research by Stephen Gorard and Nadia Siddiqui which showed that grammar schools worsen social stratification but do not increase pupil achievement. Dividing pupils into the most able and the rest from an early age, the researchers concluded, ‘does not appear to lead to better results for either group, even for the most disadvantaged. This means that the kind of social segregation experienced by children and young people in selective areas of the United Kingdom, and in selective schools and countries around the world, is for no clear gain … the findings mean that grammar schools endanger social cohesion for no clear improvement in overall results. The policy is a bad one and, far from increasing selection, the evidence-informed way forwards would be to phase out the current 163 grammar schools in England.’

Given the weight of evidence against it, any further expansion of selection in education, as envisaged by current education secretary Damian Hinds, could only be explained by ideological motives or by a desire to further reduce social mobility and increase segregation. Any government serious about addressing inequality and social mobility would look closely at how to reduce the stratification in the education system, from private schools to our increasingly two-tier higher education system. Around the world, successful economies are opening up their education systems and creating opportunities that are genuinely lifelong and lifewide. Britain, meanwhile, appears in thrall to a vision of selection grounded in class and social snobbery. The weight of our illusions keeps us from rising higher.

The low priority successive governments have attached to social mobility is reflected in the comparative neglect of further education, where state investment is likely to have the most social impact. The low status of the sector is evident from the number of ministers and secretaries of state who have been responsible for it over the years, and the really remarkable policy churn FE has been subject to over several decades. No service could reach its full potential under conditions of near-constant reform and ever shifting expectations and priorities. There is also a major funding gap between FE and HE which will need to be closed by some means if the UK is to deliver the higher-level technical skills it will require to compete on equal terms with comparable countries.

Justine Greening, the only recent education secretary who has taken social mobility seriously, was sacked shortly after producing her ‘plan for improving social mobility through education’. Her ambition was admirable though the proposals themselves, while positive, were not nearly radical enough to ‘transform equality of opportunity in this country’. The problem needs to be approached in a more comprehensive and joined-up way, with the place of further education considered in the context of the wider education system and significant resource put into spreading opportunity more evenly and creating routes for people at every stage of life. Ms Greening’s ‘social mobility pledge’, intended to encourage employers to engage more with schools and colleges, is a good idea, but it needs to be part of a much wider, longer-term strategy that is not afraid to challenge the sacred cows of selection, the private school system, A-levels and mass higher education.

Education is not a silver bullet when it comes to social mobility and inequality. Real change would require strong political will in every department of government. To be lasting and fundamental it would also need public support which, I fear, will require a shift in our political scene as yet undreamt of. But, for all that, it is not a bad place to start. If we can challenge the perpetuation of inequality of opportunity in education we can certainly change it elsewhere. For that, though, we will need real leadership and commitment at the top of government, and a genuine willingness to challenge beliefs and cultural norms that hold working people back and allow the privileged to horde opportunity for themselves and their children. That would be an Easter message worth sharing.