Health
Helping Kids Thrive Online Health, Safety, & Privacy
The impact of the use of online platforms on young people’s health has been a focus of significant research and policy deliberation in recent years. In December 2023, the National Academies of Sciences, Engineering and Medicine (NASEM) published a report of a consensus study, Social Media and Adolescent Health, which offers a comprehensive scientific review of existing research.26 The report found evidence of benefits to adolescents associated with social media usage: social connections, combatting isolation, learning opportunities, self-expression, and civic engagement. It also identified evidence of harms associated with social media usage: social comparison, displacement of other activities, interference with attention and learning, sleep disruption, overuse and problematic use, and sexual exploitation and abuse. As the report and other work has identified, these impacts are gendered: girls may disproportionally have more negative interactions and experiences online than boys do.27 28
There are key limitations in research analyzing the impact of social media on young people. For example, many of the existing studies are correlational and cross-sectional. Such studies find that young people who spend a lot of time online also often have issues with sleep.29 30 31 Whether youth are not sleeping because they are spending time online or are spending time online because they are not sleeping is much more difficult to conclusively establish, thus limiting our ability to evaluate the impact of time spent online or the efficacy of interventions.
Studies also demonstrate a wide variation in the impact of social media on individuals, which can make it difficult to draw broad conclusions. For some youth, the impact may be significantly negative, whereas for others, it may be significantly positive.32 Additionally, many studies lack the specificity necessary to inform specific interventions. For example, many studies use constructs like “screen time”—that is, the amount of time youth spend on their screens—which is not, in and of itself, a robust enough predictor of outcomes.33 Given differences in research designs and measurements, a number of empirical findings appear to contradict one another, likely indicating, as the Surgeon General has stated, that “the relationship between social media and youth mental health is complex and potentially bidirectional.”34 35
However, despite a lack of consensus among researchers about causal links across all demographics, ages, and types of social media and online platform use, there remains significant concern that social media use in general has not been proven safe for youth.36 The risks of harm raised by the research to date, including potentially increased levels of depression, loss of sleep, and inability to detach from their devices—along with concern expressed among parents, youth, and the general public—warranted the Surgeon General Advisory in 2023 titled Social Media and Youth Mental Health, which concludes that excessive and problematic use of social media and exposure to extreme and inappropriate content can have a profound risk of harm to the mental health and well-being of youth.37 As the Task Force was finalizing its work, the Surgeon General followed up in June 2024 with a call for warning labels on social media platforms.38 Current evidence suggests that passive and active social media use are associated with depression, anxiety39 40 41 42 and suicide43 44 among specific groups of adolescents.
The use of social media and other online platforms can influence key developmental processes that occur throughout childhood, especially during adolescence.45 46 These include:
- Identity Development and Exploration. The Digital world offers a much larger environment for youth to develop and explore their identities. Many young people curate and post content that projects what they perceive to be the best reflection of themselves. These online images can be psychologically affirming. However, curated content can also have the potential to be psychologically harmful as youth strive to live up to images projected by their peers, corporate influencers, and mass media.47 48 49 50 51
- Self-Disclosure. Some youth may share personal information or secrets about themselves with their friends and peers. This can be instrumental in finding community and belonging.52 53 However, when disclosures occur online, they can result in negative outcomes related to exposure to multiple unrelated or unintended audiences,54 loss of privacy, and increased feelings of vulnerability.55
- Social Status and Feedback. Attaining social status and acceptance among peers are central features of adolescent development.56 In the online world, there are quantifiable ways of assessing status and belonging—for example, the number and identity of “likes”— heightening social comparison in ways that can lead to psychological distress.57 58
- Finding People “Like Me.” Young people—including those who feel lonely, different, stigmatized, or ostracized in the offline world—can find community online.59 However, the public nature of online expression can stifle expression60 and youth may be drawn into communities that ultimately propel them to commit violence against themselves or others.61 62
Focus Issue: Problematic Use/Excessive Use
Even if the activities a young person is engaging in online are not harmful or distressing, the mere experience of excessive use can threaten health and well-being by disrupting healthy behaviors. According to a recent survey, half of U.S. teenagers (51%) report spending at least four hours per day using a particular set of social media apps.63 Usage varies by age, with 42% of 13-year-olds using these social media apps for more than four hours per day and 62% of 17-year-olds reporting spending more than four hours per day on them.64 Only 10.5% of teenagers spend one hour or less on social media, while nearly 30% spend six hours or more on social media.65
Excessive and problematic social media use is associated with sleep problems, attention problems, and feelings of exclusion among youth.66 67 68 69 Existing studies have found a consistent relationship among poor sleep quality, reduced sleep duration, sleep difficulties, depression, altered neurological development, and suicidal thoughts and behaviors.70 71 72 On a typical weekday, nearly 1-in-3 adolescents report using screens until midnight or later.73 Some research suggests that technology’s interference with sleep is one of the key ways that social media use may contribute to mental health challenges among young people.74
Social media platforms are often designed to maximize user engagement, which has the potential to encourage excessive use and the inability to regulate emotional responses through features such as push notifications, autoplay, infinite scroll, and engagement-driven algorithms for content recommendations. Some experts say that autoplay settings feed into risks of harm by exploiting psychological triggers, such as the fear of missing out, to keep users engaged and scrolling. Dark patterns are user interfaces designed to steer or mislead users into making unintended and potentially harmful decisions. In the context of kids online, dark patterns can be used to nudge or manipulate youth to make it more difficult for them to log off their devices and disconnect.75 76 77 78
26 National Academies of Sciences, Engineering, and Medicine"Social media and adolescent health." The National Academies Press. (2023).
27 Cingel et al, "Social media and adolescent health, at 97" National Academies of Sciences, Engineering, and Medicine (2022).
28 K. Regehr, C. Shaughnessy, M. Zhao, N. Shaughnessy, UCL IOE, “SAFER SCROLLING How algorithms popularise and gamify online hate and misogyny for young people,” University of Kent (Feb 2, 2024).
29 R. van den Eijnden et al., "Social Media Use and Adolescents’ Sleep: A Longitudinal Study on the Protective Role of Parental Rules Regarding Internet Use before Sleep." Int J Environ Res Public Health. 2021 Feb; 18(3): 1346.
30 D. Yu et al, "The Impact of Social Media Use on Sleep and Mental Health in Youth: a Scoping Review." Curr Psychiatry Rep. 2024; 26(3): 104–119.
31 A. Khan et al., "Intense and problematic social media use and sleep difficulties of adolescents in 40 countries." Journal of Adolescence (preprint). (2024)
32 Social Media and Adolescent Health, "Comm. on the Impact of Social Media on Adol. Health" Board on Pop. Health and Public Health Prac.; Health and Med. Div.
33 A. Orben and A. Przybylski, “The association between adolescent well-being and digital technology use,” Nature Human Behaviour (February 2019): 177-178.
34 P. Valkenburg , A. Meier, and I. Beyens "Social media use and its impact on adolescent mental health: An umbrella review of the evidence." Curr Opin Psychol. (2022): 44:58-68. doi: 10.1016/j.copsyc.2021.08.017. Epub 2021 Aug 18. PMID: 34563980.
35 H. Shannon, K. Bush, P. Villeneuve, K. Hellemans, and S. Guimond, "Problematic Social Media Use in Adolescents and Young Adults: Systematic Review and Meta-analysis." JMIR Ment Health. (2022): 9(4):e33450. doi: 10.2196/33450. PMID: 35436240; PMCID: PMC9052033.
36 Office of the Surgeon General (OSG). "Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory. Washington (DC): US Department of Health and Human Services" (2023).
37 Office of the Surgeon General (OSG). "Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory. Washington (DC): US Department of Health and Human Services" (2023).
38 Murthy, V., Surgeon General "Why I’m Calling for a Warning Label on Social Media." New York Times.
39 S. Prasad, S. Souabni, G. Anugwom, K. Aneni, A. Anand, A. Urhi, and F. Oladunjoye, "Anxiety and depression amongst youth as adverse effects of using social media: A Review." Annals of Medicine and Surgery, (2023): 85(8), 3974-3981.
40 B. Keles, N. McCrae, and A. Grealish, "A systematic review: the influence of social media on depression, anxiety and psychological distress in adolescents." International journal of adolescence and youth, (2020): 25(1), 79-93
41 M. Selfhout, S. Branje, M. Delsing, T. ter Bogt, and W. Meeus, "Different types of Internet use, depression, and social anxiety: The role of perceived friendship quality," Journal of Adolescence, (2009): 32(4), 819-833.
42 J. Nesi, and M. J. Prinstein, "Using social media for social comparison and feedback-seeking: Gender and popularity moderate associations with depressive symptoms." Journal of Abnormal Child Psychology, (2015): 43, 1427-1438.
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46 E. Galinsky, "The Breakthrough Years," Flatiron Books, (2024)
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50 E. Vogels, R. Gelles-Watnick and N. Massarat, “Teens, Social Media and Technology 2022,” Pew Research Center, (August 10, 2022).
51 C. Bryan, D. Yeager and C. Hinojosa, “A values-alignment intervention protects adolescents from the effects of food marketing,” Nature Human Behaviour, (2019): 3 no. 6, 596-603.
52 N. Vijayakumar et al., “Getting to know me better: An fMRI study of intimate and superficial self-disclosure to friends during adolescence,” Journal of Personality and Social Psychology, (2020): 118, no. 5, 885–899.
53 N. Vijayakumar, and J. Pfeifer, “Self-disclosure during adolescence: Exploring the means, targets, and types of personal exchanges,” Current Opinions Psychology (2020): 31, 135-140.
54 A. Marwick, and D. Boyd, "I tweet honestly, I tweet passionately: Twitter users, context collapse, and the imagined audience." New Media & Society, (2011): 13(1), 114-133.
55 N. Lapidot-Lefler, and A. Barak. “Effects of anonymity, invisibility, and lack of eye-contact on toxic online disinhibition.” Comput. Hum. Behav. (2012): 28, 434-443.
56 D. Yeager, R. Dahl, and C. Dweck, “Why interventions to influence adolescent behavior often fail but could succeed,” Perspectives on Psychological Science : a Journal of the Association for Psychological Science, no. 1 (2018): 13, 101-122.
57 L. Sherman, A. Payton, L. Hernandez, P. Greenfield, and M. Dapretto, "The power of the like in adolescence: Effects of peer influence on neural and behavioral responses to social media," Psychological science, 27(7), 1027-1035.
58 H. Lee, J. Jamieson, H. Reis, C. Beevers, R. Josephs, M. Mullarkey, and D. Yeager, "Getting fewer “likes” than others on social media elicits emotional distress among victimized adolescents," Child Development, (2020): 91(6), 2141-2159.
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