President's Message:

Ellen Beckjord, PhD, MPH, FSBM, SBM President

Health takes time. This seems like an obvious, simple statement, but it’s one I find bears repeating often, because a hallmark feature of modern American life is the implicit expectation that everything should happen instantly and nothing should require time. Some of you may be too young to remember that a lot of things that don’t take time today were things for which we had to wait not too long ago. Simple examples include having to wait to hear your favorite song on the radio (and if you were into mix tapes like I was, hovering over your boom box to hit the RECORD buttons at exactly the right moment). We used to have to take time to go into banks to deposit checks. We used to have to take time to travel to health care provider offices for physical and behavioral health services. We used to have to take time to travel to see the faces of the people we love (and we used to have to wait for their letters to arrive in the mail).

I enjoy the dramatic reductions in the time requirements of many things as much as the next person. These reductions can be reasonably characterized as “conveniences,” and most if not all, are made possible by technology. But two ideas are perpetually on my mind regarding time: how do these conveniences affect our expectations? And how do we think about control over choices we make about how we spend our time as a significant source of inequity?

Recently, I made a conscious decision to avoid using the phrase “make time.” For example, I no longer say to someone, “Thanks for making time for this” and I don’t say things like, “I can make time for that tomorrow.” We can’t make time, we can only take it. I thank people for taking time and I let others know when I plan to take time to get something done.

I am currently taking a lot of time for my health. I have committed to a half-Ironman on August 18, 2024. I’ve been training since January 2024, and as I enter the last nine weeks of my training program, the time requirements have gone up significantly, mostly due to longer bike rides as part of my workouts. As I take three to five hours on Saturday and Sundays to complete my training (in addition to the 30 to 90 minutes I take four other days of each week), I notice from where I’m taking the time. Some of it comes from time I would normally spend keeping my house in order. Some of it comes from time I would normally spend sleeping or working. Some of it comes from time I would spend with my 15-year-old daughter, other family, and friends. For me, given my personal and professional situations, the amount of time I’m taking each week to train for the half-Ironman isn’t sustainable, but I am able to put various strategies into place to make it doable until I complete the race. And my ability to manage this is not a function of virtue or my willpower, it’s a function of the privileges I enjoy, some of which are earned and many of which have been granted to me, that empower me choose how I spend my time.

Almost everything related to health – how we move, connect with others, nourish our bodies, rest, attend to physical and behavioral health needs – takes time. It’s so critical that we remember this, because the context of modern American life is often here to tell us that nothing, including health, should take any time at all. But I have yet to find a way to obtain and maintain health without taking time, and scarcity of time, even for the most privileged among us, is a real threat to health. For people who are traditionally underserved, disenfranchised, and/or affected by systemic racism or discrimination, scarcity of time can be a huge issue, as can lack of autonomy over how one’s time is spent. This is a significant source of health inequity and exacerbates health disparities. About a year ago, I did a strength training session with a colleague at the gym in the building where I work. We took a photo to celebrate our being there, taking time to attend to our health. Afterwards, looking at the photo, I felt humbled, less sure there was something to celebrate and more convinced that the photo was evidence of how privilege facilitates health: sure, I had done a workout, but I did it at 4:30 pm at a gym in the building where I work, and within that statement there are about five different examples of privileges I have that many don’t.

And so I think a great deal about the kinds of interventions that might level the playing field when it comes to time, and often am discouraged by how difficult such interventions are to design, much less implement, since time is such a commodity in modern American life in ways that health is not. For now, I have only arrived at finding some value in recognizing time, and in particular, scarcity of time, as a critical contextual factor that we cannot lose sight of as we design and implement behavioral medicine interventions intended to positively affect individual and population health (you can expect some programming around this idea at SBM 2025, pursuant to our theme: “Context Matters”).

The more our interventions account for the time requirements of health, and the more our educational and communication strategies acknowledge the role that time plays in health, the more likely we are to empower everyone to take time in ways that align with their health-related needs, preferences, and values, and the more likely we are to disproportionately support those who are not positioned to take control of their own time.  I’ll end by thanking you for taking the time to read this, and for the time you take to participate in the Society of Behavioral Medicine. Both are deeply appreciated!