Time in Health Promotion and Public Health

Abstract Being physically active and eating fresh foods could reduce the growing burdens of cardiovascular disease, cognitive decline, obesity, some cancers, diabetes type II, depression, and anxiety. Increasing these health behaviors has been a public health focus for decades, yet over one half of adults around the world remain insufficiently physically active and four in ten are overweight or obese. When people are asked why they don’t exercise more or eat healthy food, the most common reason they give is lack of time. Everyone has 24 hours in a day, so why do so many people say they lack time to be healthy? Time is a challenging (and intriguing) concept. Usually, time is thought about in terms of hours and minutes which evenly divide a day, and its lack a consequence of misguided priorities. This assumes that all hours are equal and available for use and that every person has agency over their time. Although having sufficient time is fundamental to health (exercising, preparing healthy food, resting, accessing services, and maintaining social bonds all take time), other dimensions such as control, flexibility, intensity, and timing are essential for understanding how time and health are connected. Like income, time is exchanged and given within households, so it can be fruitful to view time as a household resource rather than an individual’s resource. In the labor market, time is exchanged for payment, and this underscores time’s potency as a social and economic resource. Historically, research on the social determinants of health and health equity have focused on the harms linked to work hours, including the length and timing of the work day and flexible hours. Yet this research missed the importance of time outside the labor market, which alters the health consequence of work hours, delivering only a partial analysis of how time shapes health. Research since the early 2000s is supplying new evidence of the interplay between work, care, and other non-market time, allowing a more accurate insight into how time shapes health and how this relationship connects to social and gender equity. Debates remain, however, and these include the extent to which time pressure and time scarcity are problems of motivation and perception and whether time scarcity is a problem of only the affluent. There are precedents to address time costs and inequities. A first step for health prevention and health promotion practitioners is to value time in ways comparable to how the field values money. This would mean limiting the time costs of health interventions and services, including the requirement to “find time” outside of work or care roles to be healthy. The field also needs to challenge the idea that the income-poor are time-rich since this is rarely the case if they are caregivers. As well as minimizing time burdens, policies to address the social determinants of time from urban planning, transport systems, and work-hour regulations will be critical to achieving a fairer and healthier world.