Surgeon General Warns Social Media Poses ‘Profound Risk’ to Young People

May 24, 2023 by Dan McCue
Surgeon General Warns Social Media Poses ‘Profound Risk’ to Young People
FILE - U.S. Surgeon General Dr. Vivek Murthy testifies before the Senate Finance Committee on Capitol Hill in Washington, on Feb. 8, 2022. (AP Photo/Susan Walsh, File)

WASHINGTON — While social media use may be beneficial to some people, the U.S. surgeon general warned Tuesday that not enough is being done to fully understand or address the likely harm it does to the mental health and well-being of children and young adults.

Dr. Vivek Murthy spelled out these concerns in a 19-page advisory released Tuesday afternoon.

Though such pronouncements from the nation’s top health official lack the power of a statute or agency regulation, they are often seen as shining a spotlight on “urgent” public health issues.

In this case, the report not only lays out Murthy’s cautionary opinion, but also provides practical recommendations to help policymakers, health professionals and parents assess social media use and address any negative repercussions from it that they find.

The release of the report is also noteworthy for being the second time the surgeon general has accused social media of being a threat to public health.

In 2021, as the COVID pandemic raged, Murthy issued an advisory slamming Twitter, Facebook and others for spreading misinformation about the virus and vaccines and called on the companies to make changes to their algorithms and base infrastructure that would favor fact-based sources of information.

The new report begins with a statement that should be evident to anyone acquainted with the planet Earth in the 21st century — social media use by youth is nearly universal.

“Up to 95% of youth ages 13-17 report using a social media platform, with more than a third saying they use social media ‘almost constantly,’” the report says.

It goes on to say that while 13 is commonly the required minimum age used by social media platforms in the U.S. — as a result of the passage of the Children’s Online Privacy Protection Act — nearly 40% of children ages 8-12 find their way onto these platforms anyway.

Among the most pressing problems with this, Murthy says, is the absence of any independent, in-depth analysis of how all of this is impacting the young people whose eyes are glued to their screens.

Even without it, he says, “There are ample indicators that social media can also have a profound risk of harm to the mental health and well-being of children and adolescents.”

His recommendations for policymakers include:

  • Creating age-appropriate health and safety standards for social media use by children and young adults.
  • Requiring more data privacy protections for kids.
  • Funding future research.
  • Supporting digital- and media-literacy education in schools.
  • Requiring tech companies to share health-related data.

As for those tech companies, Murthy recommends they:

  • Run independent assessments on the impact of their products on kids.
  • Share findings and underlying data with independent researchers.
  • Develop methods to address complaints and requests from young users and their families and educators in a timely manner.
  • Prioritize health and safety in designing products.

In the home itself, Murthy says parents should:

  • Set expectations and establish in-house rules for how technology should be used.
  • Carve out tech-free zones at dinner or before bedtime.
  • Share their success stories and concerns involving social media with other parents.

Murthy, of course, isn’t the only one taking a hard look at social media of late.

Just last week, Montana became the first state in the U.S. to ban Chinese-owned TikTok over national security concerns, threatening to fine the company and corporate alter ego Chinese internet company ByteDance $10,000 per day for each violation.

Those fines could ramp up quickly once the law goes into effect on Jan. 1, 2024, as TikTok says it currently has more than 150 million users in the U.S., and the number continues to climb.

Whether the Montana law stands long enough to actually go into effect is another story.

Almost as soon as the state’s Republican Gov. Greg Gianforte signed the bill into law, the state was sharply rebuked by the American Civil Liberties Union and others who argue the law is an unconstitutional violation of free speech rights.

Within hours, five TikTok content creators living in the state made the same argument in a federal lawsuit seeking to overturn the law, and on Monday, TikTok itself filed a federal lawsuit seeking to quash the ban.

Among other things, the lawyers for the popular social media platform contend national security issues are not something state officials are empowered to regulate, as the Constitution squarely makes foreign affairs and related matters a federal issue.

So far, nothing in the Montana litigation appears to touch on the same issues that concern the surgeon general.

However, a new law in Utah definitely does.

In March, Utah’s Republican Gov. Spencer Cox signed what has been described as “sweeping” legislation that bans anyone under the age of 18 from using social media unless they have their parents’ consent and also expressly prohibits social media companies like Twitter, Facebook and TikTok, from advertising to minors, collecting information about them or targeting content to them.

The laws, which go into effect in March 2024, will also give parents and guardians full access to all of their children’s posts.

“We’re no longer willing to let social media companies continue to harm the mental health of our youth,” Cox declared on Twitter after he signed the bills.

The same day Cox was busy signing bills in Utah, TikTok CEO Shou Zi Chew was in Washington, D.C., being grilled by members of the House Energy and Commerce Committee.

During his more than five hours on the Hill, Chew repeatedly denied the TikTok app shared U.S. users’ information with the Chinese government and attempted to reassure committee members that his company is doing everything it can to protect children’s mental health.

Unfortunately for TikTok, Chew’s testimony appeared to only fuel further calls to ban the platform nationwide.

Rep. Kathy Castor, D-Fla., accused the company of knowingly promoting content that encouraged children to develop eating- and other mental health-related disorders.

“TikTok could be designed to minimize the harm to kids,” she said. “Instead a decision was made to aggressively addict kids in the name of profits.”

Instead of pushing back at Castor’s assertion, Chew said the issues she raised were complex and not unique to his social media platform.

Another Florida Democrat, Rep. Gus Bilirakis, then had a collection of TikTok videos shown to the committee to illustrate how the platform appears to glorify self-harm and suicide.

“Your technology is literally leading to death,” Bilirakis said, his eyes laser-focused on Chew. 

“We must save our children from big tech companies like yours, who continue to abuse and manipulate them for your own gain,” he said.

Chew told the committee TikTok takes the issues Bilirakis raised “very, very seriously,” adding that the company is investing in artificial intelligence and other content-moderating technology to limit such content.

The advisory noted that social media companies have a vested business interest in keeping users online, and even allowed that they can play a positive role, providing young people with a way to connect with others and express themselves.

The continuing problem, the surgeon general says, is that in the process, “extreme, inappropriate, and harmful content continues to be easily and widely accessible by children and adolescents.”

“This can be spread through direct pushes, unwanted content exchanges, and algorithmic designs,” the report states. “In certain tragic cases, childhood deaths have been linked to suicide- and self-harm-related content and risk-taking challenges on social media platforms.”

“This content may be especially risky for children and adolescents who are already experiencing mental health difficulties,” Murthy said. 

He goes on to note that a systematic review of more than two dozen studies found that some social media platforms show live depictions of self-harm acts like partial asphyxiation, leading to seizures, and cutting, leading to significant bleeding. 

“Further, these studies found that discussing or showing this content can normalize such behaviors, including through the formation of suicide pacts and posting of self-harm models for others to follow,” the surgeon general said.

The report also found that social media may perpetuate body dissatisfaction, disordered eating behaviors, social comparison and low self-esteem, especially among adolescent girls. 

It references 20 different studies that the surgeon general says demonstrated a significant relationship between social media use and body image concerns and eating disorders, with social comparison as a potential contributing factor. 

When asked about the impact of social media on their body image in one study, nearly half (46%) of adolescents aged 13-17 said social media makes them feel worse, 40% said it makes them feel neither better nor worse, and only 14% said it makes them feel better, the report said.

Additionally, roughly two-thirds (64%) of adolescents are “often” or “sometimes” exposed to hate-based content while using social media.

Among adolescent girls of color, one-third or more report exposure to racist content or language on social media platforms at least monthly. 

In a review of 36 studies, the surgeon general said, a consistent relationship was found between cyberbullying via social media and depression among children and adolescents, with adolescent females and sexual minority youth more likely to report experiencing incidents of cyberbullying.

Nearly 75% of adolescents say social media sites are only doing a fair to poor job of addressing online harassment and cyberbullying, the report said.

Earlier this month, the American Psychological Association issued its first-ever social media guidance, recommending that parents closely monitor teens’ usage and that social media companies take steps that disable even seemingly innocuous features like endless scrolling that contribute to prolonged sessions on their platforms.

Dan can be reached at [email protected] and at https://twitter.com/DanMcCue

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