Table 1.

The impact of time poverty on women’s health and economic prospects*

Health:
Time poverty promotes self-neglect	• Limited discretionary time due to a large caregiving burden can prevent women from seeking their own medical care [S1]. In 2017, 24% of American women reported delaying or not obtaining health care because they could not find time, and 14% cited trouble finding child care [S2].
	• In a study of HIV patients in the United States, being female and having a child in the household were both predictors of delaying HIV care due to caregiving [S3].
	• Among pregnant South African women, daily chores such as fetching water and fieldwork have been shown to decrease use of prenatal care [S4].
	• Among pregnant women in Benin, educational attainment and being employed – which require sufficient time – were associated with increased utilization of maternal health care [S5].
Time poverty prevents women from earning money, which can limit their ability to pay for health care	• In a study of rural Bangladeshi women, a lack of income-generating activity was associated with increased delay in seeking emergency obstetric care [S6].
Time poverty curtails women's educational opportunities and capabilities for enagaging with health systems	• A study of Aboriginal women in Manitoba found that caregiving responsibilities were a significant barrier to academic progress [S7].
Time poverty results in poorer food choices, less exercise, and more stress	• Time poverty promotes unhealthy eating habits and decreased exercise [8]. Conversely, in a review of the impact of leisure time on health, leisure time was associated with identity formation and affirmation, improved coping during times of stress, and positive effects on work and relationships [S9].
	• A 2017 study found that American fathers engaged in leisure activities 47% and 35% of the time during which mothers did childcare and housework, respectively [S10].
	• Caregiving can also be mentally and physically taxing. Among American women caring for adult relatives, mental health is worse than national norms [S11]. Grandmothers who take significant caregiving roles for their grandchildren have been to shown to suffer increased stress compared to non-caregiving counterparts [S1].
Economic prospects:
Unpaid responsibilities limit women's engagement in the workforce	• Worldwide, three-quarters of men and one half of women are part of the paid labor force [S12]. In 2015, <30% of women in Northern Africa, Western Asia, and Southern Asia worked for pay [S12].
	• Unpaid caregiving duties are a significant barrier to employment, particularly for mothers. In 2013, American mothers were almost three times as likely as fathers to report quitting their jobs at some point for family reasons [S13].
	• Male-dominated occupations often require long hours with little flexibility, which does not accommodate caregiving responsibilities [S14]. Mothers in these fields were 52% more likely to quit than other women if they worked ≥50 hours per week.
	• In the United States, 69% of unpaid caregivers to elderly adults are women [S15]. Daughters and daughters-in-law are more likely than other caregivers to reduce their work hours to care for ageing parents [S16].
Women in the paid workforce are funneled into lower-paid occupations with fewer protections	• Female-dominated professions such as teaching, administrative services, and food production tend to pay less than male-dominated jobs, even when they require the same skill level [S17]. They reflect women’s lower educational attainment, limited mobility, discrimination by employers, normative choices, and the necessity of part-time work to accommodate domestic work [S18]. The same trends are seen in the health sector, where “women care and men cure” [S19].
	• Women tend to occupy lower levels and be paid less than men working in the same industries. For example, in the Canadian food service industry in 2015, 60% of chefs were male, while 72% of kitchen helpers were female [S20]. Women are under-represented in high-paid sectors like technical and business services [S18,S21,S22].
	• Lower-paid roles tend to offer poorer working conditions and be excluded from social protection programs designed to reduce social and economic vulnerability [S22,S23,S24].
	• In the Middle East, legal coverage for employment injury is 18 percentage points lower for women than overall coverage rates [S25].
Gender segregation in the workplace persists due to overt and subtle harassment and discrimination	• The decline in occupational segregation by gender in the United States has significantly slowed in recent decades, regardless of the education level required for the work [S26]. In 2018, only 7.2% of American women worked full-time in male-dominated (≥75% male) fields [S27].
	• Male-dominated occupations are often hostile environments for women and have the highest rates of gender-based harassment [S28,S29]. Women majoring in majority-male fields face significantly more gender harassment than women in other majors [S30].
	• Discrimination on hiring and promoting men over women is pervasive in finance and STEM fields, limiting women's advancement and reinforcing gender-based occupational segregation [S29,S31,S32].
	• 37% of women who work mostly with men report that they have been treated as if they were incompetent because of their gender, compared to 18% of women in gender-balanced workplaces [S29].
Women are paid less than men for similar work	• Jobs with more women pay less than those with fewer, even when controlling for education level and skills [S33]. In most countries, across all sectors and occupations, women working full-time earn 70%-90% of what men earn doing the same work [S12].
	• Women earn less than men in all male-dominated occupations and 18 of the 20 most common occupations for women [S27].
	• Devaluation of women's work has been shown to be a primary driver of the gender wage gap [S33]. The overall pay rate of male-dominated occupations in the United States declined as large numbers of women entered the fields between 1950 and 2000 [S33].

*References are presented in Table S1 in the Online Supplementary Document.