As evidence mounts of the health harms of excessive social media use on children, governments and academics are mulling how to regulate and contain these harms – notably anxiety, depression and low self-esteem.

US Surgeon General Dr Vivek Murthy recently appealed to his country’s Congress to compel social media sites to carry warning labels about the potential negative effects on the mental health of teens and children. This approach is akin to that used in many countries to warn of the harms of tobacco products and alcohol.

A study of over 6,500 US teens adjusted for baseline mental health status found that those who spent more than three hours a day on social media faced double the risk of experiencing poor mental health outcomes including symptoms of depression and anxiety.

Excessive time online also cuts children off from friends and family, makes them less likely to exercise and increases their exposure to online marketing of unhealthy goods such as alcohol, cigarettes and gambling – as well as sexual predators.

But there are also educational advantages to online access, which complicates regulation. In addition, many parts of the world are still grappling with how to extend internet access to their citizens.

Approximately one billion children and young people under the age of 26 have access to the internet at home – approximately one-third of this age group and skewed in favour of high-income countries and households, according to UNICEF.

Public health approach

A viewpoint published in last week’s Lancet appeals for “a public health approach” to protect children from digital harms. 

“To build healthy digital environments for children now and future generations, we recommend a precautionary approach to governance that prioritises children’s health and wellbeing, recognises their desire to enjoy the benefits of the digital world, and allows children to have a role in shaping their digital futures,” urge the authors, Louise Holly, Prof Sandro Demaio and Prof Ilona Kickbusch.

“New algorithmic features are emerging at a rapid pace to capture children’s attention and increase platform use. Legislation is failing to keep up with these developments and children remain unprotected,” they note.

The authors suggest three broad areas for intervention: delaying the age at which children  use digital media and devices; health warnings on device packaging, digital apps, and websites and health promotion campaigns to raise awareness of the benefits of delaying digital technology use among young children. 

To achieve these, they suggest six strategies.

The first involves using the built-in technical features of smartphones and apps limit users’ time. 

“Regulations could require such time-limiting features to be strengthened to protect children and could also be set as a default on all devices, games, and apps so the onus is on users to reduce, rather than set or increase time limits,” they suggest.

The second involves increasing the cost of products such as games, apps and smartphones by taxation.

The introduction of “device-free spaces similar to smoke-free spaces” is their third suggestion.

The fourth strategy involves “comprehensive digital education”. In addition, UNESCO recommends that schools limit the amount of learning done on individual devices.

Fifth, they recommend changing the “norms around children using smartphones”, referring to how the French town of Seine-Port has banned the use of smartphones in public places after this was agreed via a referendum. 

Finally, they recommend creating offline alternatives for children such as  green spaces and sports facilities. Here they refer to Iceland’s “whole-of-society approach that includes increasing opportunities for children to engage in organised leisure activities” to reduce drug use.

Impact on girls

The US Surgeon General has also published an advisory on the impact of social media on young people highlighting its pernicious influence on girls.

“Social media may also perpetuate body dissatisfaction, disordered eating behaviors, social comparison, and low self-esteem, especially among adolescent girls,” it notes.

“One-third or more of girls aged 11-15 say they feel ‘addicted’ to certain social media platforms and over half of teenagers report that it would be hard to give up social media. “When asked about the impact of social media on their body image, 46% of adolescents aged 13-17 said social media makes them feel worse,” according to the advisory. 

“Additionally, 64% of adolescents are ‘often’ or ‘sometimes’ exposed to hate-based content through social media. Studies have also shown a relationship between social media use and poor sleep quality, reduced sleep duration, sleep difficulties, and depression among youth.”

Image Credits: UNICEF.