The association between time use and health is well-known [1, 2, 3]. For instance, spending more time in paid work and devoting more time to family and childcare can be associated with good health, but excessive time spent on housework can also lead to negative health outcomes [4]. The COVID-19 pandemic has also demonstrated a change in leisure activities with a decline in physical activity, and an increase in sedentary activities (e.g., screen-based), and in turn poorer mental health [5, 6, 7, 8]. Therefore, it is important to find and promote the right balance between demanding and relaxing activities that supports positive mental and physical functioning. To harmonize time-use research and support these efforts, scientists have developed categories of time use, to capture different types of time use and examine their association with health. In his seminal work, As [9] discerns necessary (e.g., hygiene), contracted (e.g., paid work), committed (e.g., housework), and free time (e.g., arts), which can be connected to subsequent health trajectories. This categorization has been utilized in multinational time-use surveys [10, 11], and connected to health. For instance, lower quality of life in unemployed persons with lower contracted time [12] or higher quality of life in persons with more artistic activities in their free time [13].

The present study examines time-use categories in relation to health-related quality of life (HRQoL), that is “perceived wellbeing in physical, mental, and social domains of health”([14], p. 195). The term HRQoL is used as the overall concept, while in the present analyses life satisfaction as well as self-rated health are examined. Sociodemographic and economic background—especially gender—has been shown to be an important predictor of HRQoL [15, 16].

In recent years, a gender perspective has enriched this research by asking questions about gender roles and ideologies, meaning individual (gender roles) and collective (gender ideologies) beliefs about the division of responsibilities and tasks between genders, for instance regarding work and family [17, 18, 19]. From a theoretical perspective, feminist theories, for instance, question the validity of traditional conceptualizations of work-family-balance with distinct roles of providers and carers, and propose more nuanced, gendered perspectives instead (e.g., reflecting on the symbolic meaning of unpaid housework as an act of love, and an equal contribution to paid work, [20, 21]). Individual perceptions of daily activities (e.g., childcare, housework) are also influenced by intra- and interindividual standards and expectations, which determine time and effort spent on a task, and subsequently positively or negatively evaluating said time use. In previous studies, women reported higher standards regarding housework and were often disappointed by their male partners, which led to marital distress and the women completing these tasks [21]. Performing said tasks can also be described as doing-gender [22], with women fulfilling expectations and social norms. Other approaches like the marital-power framework associates an imbalance of resources favouring men (e.g., via institutional preference in the workplace) with a power imbalance in marriages that leads to women performing more undesirable activities like housework (e.g., [17]). Further analysis of gender perceptions reveals differing preferences and interpretations of roles (e.g., within the workplace, social settings, and families that directly or indirectly affect time use) and psychosocial health, for example, valuing social integration over career success corresponds to social expectations towards women but can lead to role disengagement at work and thus foster work-family conflict [23]. Social perspectives and institutional, and thereby, societal structures are intertwined with individual perceptions and actions regarding time use. In a study on gender and career success, Frear et al. [24] found support for both the unequal attributes model (i.e., differing attributes like job status, family-related values, and personal resources mediate gender differences in career success) as well as the unequal effects model (i.e., gender moderates the impact of attributes on career success). These findings imply that both, institutional contexts as well as individual expectations and resources affect career success and consequently determine time spent on career development (e.g., contracted time). Overall, current research directions range from cross-cultural comparisons of ideologies (e.g., egalitarian, traditional) and their association with work-family policies [25] to studies on individual perceptions [24]. Regarding time-use research, the association of gender, time-use patterns, and health is complicated: For instance, higher levels of multitasking work, housework, and childcare in women compared to men are related to lower happiness, life satisfaction, and quality of life [19, 26, 27, 28]. In essence, unpaid care work has been identified as a core aspect of gender inequality across countries ([4, 17, 18, 29, 30, 31]), and it is associated with negative emotions and psychological distress, particularly in women [32, 33]. In line with feminist theory, this could symbolize an imbalance of resources with women receiving insufficient esteem or not being sufficiently valued for their contributions [20, 21]. Women also have less time for personal care and leisure activities [34] that limits the self-regulatory potential of time use to achieve life-domain balance [23]. Moreover, men are less likely to reduce working hours to increase time spent on childcare to alleviate their partner’s stress levels [30], which might lead to further conflict and stress. It is important to note that these effects vary based on the operationalization of time use. In a large meta-analysis, Shockley et al. [35] did not find strong empirical support for gender differences, yet they focused on work-family conflict (as one specific subtype of gendered time use) and did not examine country-level effects, like national policies.

To reiterate, the gendered association between time use and health is strongly affected by sociodemographic characteristics and societal context. For instance, becoming unemployed and unemployment status affect men’s wellbeing more negatively than women’s [36, 37, 38], which is linked to their contracted time. Higher contracted time is also associated with less necessary time (e.g., sleep, self-care) but better self-rated health across countries [2]. Gender policies on a national level—e.g., regarding childcare—also influence gendered time use: in Sweden and other Scandinavian countries, time spent on work and childcare is more similar in men and women than in Italy [39, 40]. Despite a large body of research in this area, few studies have prospectively investigated the interplay of gender, sociodemographic factors (e.g., employment status), time use, and psychosocial health in population-based samples. To date, many studies are either cross-sectional, assess only one aspect of time use (e.g., contracted time) or focus on a single socio-economic factor (e.g., income, employment status) in relation to gender. Moreover, bidirectional effects (i.e., of health status on time-use and vice versa) also need further attention.

To add to the literature, this study presents a longitudinal analysis of panel data to answer the following research questions: How does the relationship between types of time use and HRQoL compare across genders? Which bidirectional effects emerge over time? And, which of these associations are significant above and beyond controlling for sociodemographic variables?