Ageing well takes time

Public health programs are usually built around short funding cycles and fast results: a set number of visits, a target number of people reached, a report due within the year.

Older adults left behind by migration, however, don't experience their circumstances on that kind of schedule. Trust takes time to build, grief and loss reshape a life gradually, and communities change over decades rather than fiscal quarters.

This mismatch in timelines may explain why well-intentioned programs often fail to take root.

Across large parts of the Global South, young people are leaving villages and small towns for cities and richer countries, chasing jobs and opportunities. Left behind are older parents and grandparents, often without the family support that once cared for them as they aged.

The usual response relies on quick programs, measurable targets, and standardised services. This approach is often poorly suited to this challenge. Slow Public Health takes a different approach. It assumes that trust and genuine support need time to develop. Moving too quickly can do more harm than good.

What older adults lose when families leave

Conventional public health tends to treat communities as places to deliver a program, measure results, and move on. When a village loses its young people, a quick fix may be to schedule visits for isolated older adults or provide phones for family contact. Success is often judged by the number of visits made or the number of people using the technology.

Slow Public Health asks a different question. Instead of arriving with a ready-made solution, it starts by listening:

• What has this person actually lost?

• What still brings them joy?

• Who already helps them, and who do they help in return?

Migration doesn't just remove a caregiver. It often removes someone whose own life had meaning partly through caring for others. Older adults are not just people with needs. They carry skills, memory, and knowledge built up over a lifetime, resources that quick, standardised programs tend to overlook.

A grandmother who taught half the village's daughters to save money in ways that actually worked, or a grandfather who taught them to graft fruit trees, doesn't stop being that person once the family that anchored them has moved away.

Ageing happens on different timelines

These are not just losses to be counted, but changes that unfold at different speeds. This is part of what makes this approach different: it takes time itself seriously, not just as something to save, but as something with different layers:

1) A person's own time: how slowly habits, identity, and outlook shift as someone grows older.

2) A generation's time: how shared experiences, such as war, migration, or economic hardship, shape how a whole group of people ages.

3) A community's time: the slower, longer-running forces, like history and unequal access to services, that shape a place over decades.

A village that has spent generations with inadequate access to clinics and roads doesn't start from zero when its young people leave. Migration deepens a disadvantage that was already there. Personal and generational time show up differently.

Take the use of digital tools, such as video calls, to bridge the gap left by migrant children: a conventional approach might measure success by how many older people use the technology.

A Slow Public Health approach would ask instead how meaningful the connection actually feels. For example, instead of introducing a standardised program from outside, practitioners might spend time with local residents, learn who people already turn to for support, and build services around those relationships.

Slow is not the same as passive

None of this means waiting things out. It means paying closer attention, building real relationships, and letting communities set the pace, while still responding immediately when someone's safety or health is at risk.

A crisis still calls for a fast response. Slow Public Health is not meant to replace emergency care, and it is not a reason to withdraw services from communities that already lack resources.

The value of patience in public health

Slow Public Health is still a concept, not a tested program. It would need to be tried out in real communities to see whether taking things slower actually leads to better outcomes for older adults affected by migration.

In a field that often prizes speed and measurable results, some of the most important work, such as building trust, adapting, and forming genuine connections, cannot be rushed. An ageing population may be best served by a public health system willing to wait for that work to happen.

References:

1. Tokovska, M., & Suvada, J. (2026). Slow public health: a temporal-relational framework for migration and aging in the Global South. Frontiers in Public Health, 14, 1900909. https://doi.org/10.3389/fpubh.2026.1900909

2. Ahlin, T. (2018). Only near is dear? Doing elderly care with everyday ICTs in Indian transnational families. Medical Anthropology Quarterly, 32, 85–102. https://doi.org/10.1111/maq.12404

3. Hornby-Turner, Y. C., Peel, N. M., & Hubbard, R. E. (2017). Health assets in older age: a systematic review. BMJ Open, 7, e013226. https://doi.org/10.1136/bmjopen-2016-013226

4. Aagaard-Hansen, J., & Bloch, P. (2023). Settings, populations, and time: a conceptual framework for public health interventions. Frontiers in Public Health, 11, 1297019. https://doi.org/10.3389/fpubh.2023.1297019

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