Aspects of Time

A. Through What Social and Cultural Pathways Does Time Influence Health?

Aspects of time can be as different as age, season, schedule, calendar time, or circadian rhythm. There are many obvious ways that time influences disease risk, most notably with respect to chronological age. Age influences to which diseases and injuries human bodies are susceptible. Infectious diseases such as chickenpox or measles predominantly attack the young, conferring a level of immunity that lowers the incidence among adults. Chronic diseases such as hypertension or type II diabetes and degenerative conditions such as osteoporosis attack primarily the old. Sexually transmitted viruses such as HIV are usually spread among those old enough to be having sex, unless transmitted at childbirth or neonatally through breast milk. But categorizing a few less-recognized influences of time on disease allows us to see new challenges for health research.

Anthropologists have long paid ethnographic attention to activity changes over time, cataloguing things such as seasonal rounds, ritual cycles, and cyclical migrations. Paradoxically, however, they have played a small role in connecting those time-centered activities to health outcomes. For example, if time allocation studies could be better linked to exposure to disease risk, anthropologists might have a powerful contribution to make to studies of time as a causal agent.

Whether time is conceived as moments between breaths, crops, moon phases, rotations of the earth, or more than nine billion cycles of a Cesium-133 atom, the perception and measurement of time is a culturally constructed activity. Humans have created and adapted to the relaxed timeline and schedule of hunter gatherers as well as the tense and scheduled stresses of the urban worker. How much time is spent exercising, and how much time a nervous system spends in an excited, catecholamine-flooded state both appear to influence risk of heart disease. How much time people make available for sick children seems to influence propensity to overmedicate with antibiotics and anti-hyperactivity medications. The instruction that pills be taken "three times a day with meals" shows that cultural assumptions about the timing and frequency of meals are brought to bear in regulating health-related behavior. The perception of

Table 3.6. Recognition of malarial threat by season in Tanzania

Percent of inhabitants who recognized a grave threat from: Season

Percent of inhabitants who recognized a grave threat from: Season

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