Experts from around the world, including Canada, say the scale of digital technology use by children and youth is a public health issue that needs immediate action to prevent further harm.
A series of papers published by the Lancet on Sunday say the responsibility for keeping young people safe from problematic use of social media and other digital technology must shift from young people and their families to big tech companies and governments.
“It’s easy to think about how technology impacts our health as being about our individual choices. And one of the things that we really want to get across in this series is that that’s not the right way to think about it,” said co-author Jay Shaw, the Canada Research Chair in responsible health innovation at the University of Toronto, in an interview.
Efforts by parents, such as screen-time limits, as well as individual willpower by young people, aren’t enough to address the “digital determinants of health” that are now part of their everyday environment, the papers say.
“We need to think about the design choices and business models of big technology companies that have built these platforms that are designed for engagement and (to) keep us on (them),” Shaw said.
“That’s partly what drives the health-related consequences of the digitization of our lives.”
Digital technology itself isn’t good or bad, Shaw said, but the way social media companies make money is to keep people on their platforms for as long as possible and to collect data about their likes, what they share and what posts they come back to — information that can be used for advertising opportunities.
“A perfect example is the bottomless scroll or infinite scroll. If the page you’re looking at has no end, it makes it much more difficult to close off that sort of session or that activity,” he said.
Targeted algorithms through social media and AI chatbots are designed to promote and recommend tailored content, which keep young people interacting with the platform. For many, those properties make it addictive and lead to problematic use, Shaw said — including not being able to stop scrolling even if it doesn’t feel good anymore.
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Depression, anxiety, sleep disruption and limited physical activity were documented harms to young people associated with problematic digital media use in an “umbrella review” of 2,790 studies, the Lancet papers say.
The review also found some health benefits, including a feeling of well-being, associated with “moderate” digital media use and active video gaming.
That shows the importance of considering “the patterns of our engagement with the technology and the kind of content that we’re looking at” when assessing benefits and harms of digital media use, Shaw said.
Big tech companies have often countered claims of mental health harm by citing insufficient causal evidence, the authors say.
While the authors acknowledge it is difficult to establish cause, they say the sheer scale of digital media’s presence and the fact some people are more vulnerable to harms than others justifies taking “precautionary public health action.”
That action includes government regulation and reforming digital platforms’ business models to prioritize the well-being of young people, they say.
Australia has already imposed regulations limiting social media access to people 16 years of age and over — and dozens of other countries, including Canada, are considering similar measures, Shaw said.
Canada’s proposed policies — Bill C-34, the Safe Social Media Act and Bill C-36, the Protecting Privacy and Consumer Data Act — have “got (it) pretty much exactly right” if they pass into law, he said.
The legislation would create a Digital Safety Commission to oversee tech companies. It would also restrict young people under the age of 16 from using social media platforms.
But the legislation would also allow exemptions for companies that show “adequate safeguards in the regulated social media service for the protection of children,” according to the Parliament of Canada website.
“It’s that logic of incentivizing digital media companies to demonstrate safety that is the key, I think, to all of this,” Shaw said.
There are many positive uses of social media and other digital platforms, including education and recreation, he said, so a total ban for younger teens isn’t ideal.
“At the same time, I don’t see another effective way to encourage digital media companies to enhance the safety of their platforms for young people.”
Instagram’s age restriction is 13 and owner Meta says users under 16 have default account settings that allow parents to set screen time limits and see who their kids are messaging.
The default settings also block younger teens from messages from people they aren’t connected with and minimizes exposure to sensitive content, such as violence or promotion of cosmetic procedures.
The Lancet series drew on the lived experiences of six young adults between 23 and 30 who formed a youth advisory group.
Yifan Zhou, a 30-year-old Canadian in that group, said she agrees that social media can do a lot of good, including connecting with friends and peers over long distances and easier access to educational information.
But she has also talked with other young people about the darker side of digital platforms, including loneliness from reduced in-person connection and anxiety stemming from frequent comparison of what others are posting online to your own life.
Zhou said she also has a family member who was in their teens and exposed to online predators.
“It persisted for years before almost any of us really found out because they also felt that it wasn’t something that they wanted to discuss. They felt ashamed,” Zhou said.
“They also didn’t know that it wasn’t the way it’s supposed to be, but the kind of regulations and also the education and a lot of things weren’t in place.”
Dr. Michael Cheng, a psychiatrist at the Children’s Hospital of Eastern Ontario and the CHEO Research Institute, said he frequently sees the addictive nature and mental health harms of social media.
Years ago, when he was caring for children and youth at CHEO, “their question if they were being admitted was ‘can my parents visit? When are visiting hours or when can I call my mom or dad?’”
Now, the first question is often, “do I get to keep my cellphone?” he said.
Cheng, who was not involved in the Lancet series, said it’s important to see “a convergence that we are all around the globe becoming increasingly concerned about the same issue.”
“I remember 10, 15 years ago, those that were concerned, it felt like we were yelling and crying into the wind,” he said.
“Maybe the pendulum will swing back towards a safer side when we can design safer technologies.”
Zhou said even though digital technology has developed faster than government regulations, she believes change is possible.
“The release of this paper is something that gives me hope, and I am also quite active in the youth scene and I see that young people are more and more taking agency in terms of co-creating our own futures.
“So that part also gives me a lot of hope.”
