Features

Time or money? Why you need both to be healthy

by Bianca Nogrady

Eating well, being active and maintaining relationships: most of us know what we need to do to be healthy - we just don't have the time to do it.



[Image source: iStockPhoto | Thinglass ]

Time poor? Of course you are. Who isn't, these days? We're all desperately trying to cram two-days' worth of activity into one, and it seems like everything has to have happened yesterday.

Deadlines scream at you while yet another crumpled note from your child's school gently nudges you to volunteer your time for something. Your dog gives you THAT look then stands pointedly next to its long-neglected leash. You know you should catch that spin class and cook a healthy meal afterwards, but by the time your workday ends all you can manage is to grab some take-away and slump guiltily in front of Game of Thrones.

Sound familiar? Maybe not the exact details, but there's no doubt that time is one commodity in short supply in the modern world.

Unfortunately, being time poor doesn't just mean we're not getting things done. It's also making us sick, according to Associate Professor Lyndall Strazdins, senior fellow at the National Centre for Epidemiology and Population Health, at the Australian National University.

"Pretty much every single study that has gone out and asked people why don't you eat healthy, why don't you do more exercise  because most people these days do know that they should  [reveals] the most common reason given will be lack of time," Strazdins says.

Health trade-off

Social determinants of health  socioeconomic factors such as income, employment status, access to education, access to healthcare, access to affordable housing, transport, stress, age, and disability  are increasingly being discussed in public health circles.

We know that poverty is linked with poor health, via a range of mechanisms, but Strazdins says we're yet to grasp that time is itself a significant determinant of health, and one that we often trade away for income.

"If you have a high income you are often healthy to start with or you wouldn't be able to do that [job]. But you are probably also not doing the physical activity  if you are working long hours  and the other things that you need to do," Strazdins says.

"We know that chronic disease takes time to build up; it's those little changes in your lifestyle that will have big impacts on your health later."

Those who are worst off are those who aren't earning a high enough income to at least enable them to afford healthy food or get help around the house to get things done. It's these people who are working the long hours needed to support themselves and their families, and who may also be caring for others at the same time.

"They won't have the high incomes but they'll have very high time loads, and there's a lot of research showing they just don't do things like exercise or eat healthy food not regularly  because they have these time conflicts."

Strazdins and colleagues recently looked at the amount of time spent in care and in work, and measures of time 'intensity', which is judged by asking people how often they feel rushed or pressed for time.

They found that people who spent more than 80 hours a week on care and work felt they had poorer mental health and took part in less physical activity. But they also found the same for people who had higher scores for 'rushing'.

Interestingly, they found 'rushing' was linked to being female, being a single parent, having a disability, a sense of lack of control, and work-family conflicts.

While there isn't strong evidence of a direct link between feeling time-pressured and experiencing heart disease or stroke, some studies suggest that people who feel short on time report sleep problems, headaches and gut issues and poorer health overall.

There's a strong link between feeling time-poor and having mental health problems too. For example, one study found that time pressure predicted depression in both men and women.

The health effects of caring

Another time-poor group are those juggling work with care-giving, whether it be caring for children, elderly parents, or a family member.

"If you're combining work with care  which pretty much will be the new norm as we move into a system where we're trying to make sure as many people work as possible  then those people are particularly time-poor," Strazdins says.

Australian Council of Social Services CEO Cassandra Goldie says Australia has a real challenge in providing job opportunites which are not only adequately paid and secure, but also flexible enough to accommodate other responsibilities such as parenting and caring.

"We know increasing numbers of people are under financial pressure but are also quite understandably prioritising their desire and sense of responsibility to care for a family member who has a disability, for example, or ageing parents," Goldie says.

"It is entirely appropriate and understandable to care for parents at home as long as possible, but all of these impact on the financial circumstances of individuals."

This is why policies such as paid parental leave (PPL) can have such a huge impact, not only on the incomes of families but also on their time, both of which are likely to have a knock-on effect on health.

"Paid parental leave is a policy that gave families time and money," Strazdins says.

PPL, time and infant health

The Federal Department of Social Services report on the original federal paid parental leave scheme  which was introduced in 2010 and funded eligible families up to 18 weeks payment at the national minimum wage  showed it resulted in more mothers staying home until 18 weeks after the birth of their child, particularly mothers with lower incomes.

"The PPL evaluation found … an improvement in mothers' and babies' health and wellbeing and work-life balance particularly amongst those for whom PPL made the most difference  mothers least likely to have access to employer funded parental leave, and those with least financial security due to precarious employment," the report's author said.

They also found that the scheme was associated with a reduction in mothers: "feeling rushed and pressed for time, thus enhancing their work-life balance as a result of the additional time and security provided by the PPL".

Goldie says the World Health Organisation recommends a minimum of 26 weeks of paid parental leave, because of the demonstrated health benefits for early childhood development, breastfeeding, and bonding.

"There was overwhelming evidence that in Australia, prior to having any kind of mandated paid parental leave scheme, we had parents going back to work two weeks after their child was born because of their financial situation. They simply had to go back to get that income coming in," Goldie says.

It demonstrates how time and money are two sides of the same coin. We spend one to get the other.

This article is one in a series looking at social determinants of health. Previous stories include Understanding what really makes us sick and The Indigenous gap: social factors hit hard.