The way digital technologies are currently built and governed creates real risks to health worldwide, alongside genuine benefits, according to a new three paper series authored by 13 global experts, published in The Lancet.
A new umbrella review (a review of published reviews) for the series, covering nine million people under 25 across 121 reviews, finds consistent associations between problematic digital media use (defined by the series as addiction-like patterns of digital media use, rather than by time spent online) and a range of adverse health outcomes for children, adolescents and young adults. Author Dr Falk Müller-Riemenschneider, National University of Singapore, added, “Our global projections of how many healthy years could be lost to depression and obesity linked to excessive screen time are intended to be illustrative of the possible scale of harm.
Meanwhile, the most valuable data on how these platforms actually affect users are hidden within technology companies, limiting independent scrutiny and slowing scientific progress,” said series author Louise Holly, DTH-Lab (UK). “Most digital platforms are designed by companies to capture attention and collect data, not to protect health: features such as infinite scroll, autoplay and personalised recommendation feeds are deliberate design choices, not simply a matter of individual self-control,” said author Dr Jay Shaw, University of Toronto (Canada). “We need much more research into how these specific design choices in digital media influence the way people use the technology, instead of only investigating the impact of how long people spend online.”
The authors call for coordinated governance of digital systems, with the health and online safety of children and young people be made an immediate global policy priority. Problematic digital media use is linked to a higher risk of harm to health including common mental health problems, sleep problems, and reduced physical activity. The authors caution that the certainty of the findings for both harms and benefits is low: “The associations between problematic digital media use and health harms identified in our review are modest in size and rest on low-certainty evidence that cannot establish cause and effect. “A key recommendation of our Series is that governments should require technology companies to share data on how their features affect users’ health with vetted public-interest researchers and provide the legal and technical infrastructure to make that possible. They should not be taken as an accurate measurement of harm as, although they are based on the best available research, the certainty of the evidence is low. More research is needed to provide accurate estimates of health impacts at the population level.
