July 17, 2024

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Opinion | Surgeon General: Social Media Platforms Need a Health Warning

6 min read

One of the most important lessons I learned in medical school was that in an emergency, you don’t have the luxury to wait for perfect information. You assess the available facts, you use your best judgment, and you act quickly.

The mental health crisis among young people is an emergency — and social media has emerged as an important contributor. Adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms, and the average daily use in this age group, as of the summer of 2023, was 4.8 hours. Additionally, nearly half of adolescents say social media makes them feel worse about their bodies.

It is time to require a surgeon general’s warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents. A surgeon general’s warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe. Evidence from tobacco studies show that warning labels can increase awareness and change behavior. When asked if a warning from the surgeon general would prompt them to limit or monitor their children’s social media use, 76 percent of people in one recent survey of Latino parents said yes.

To be clear, a warning label would not, on its own, make social media safe for young people. The advisory I issued a year ago about social media and young people’s mental health included specific recommendations for policymakers, platforms and the public to make social media safer for kids. Such measures, which already have strong bipartisan support, remain the priority.

Legislation from Congress should shield young people from online harassment, abuse and exploitation and from exposure to extreme violence and sexual content that too often appears in algorithm-driven feeds. The measures should prevent platforms from collecting sensitive data from children and should restrict the use of features like push notifications, autoplay and infinite scroll, which prey on developing brains and contribute to excessive use.

Additionally, companies must be required to share all of their data on health effects with independent scientists and the public — currently they do not — and allow independent safety audits. While the platforms claim they are making their products safer, Americans need more than words. We need proof.

The rest of society can play a role also. Schools should ensure that classroom learning and social time are phone-free experiences. Parents, too, should create phone-free zones around bedtime, meals and social gatherings to safeguard their kids’ sleep and real-life connections — both of which have direct effects on mental health. And they should wait until after middle school to allow their kids access to social media. This is much easier said than done, which is why parents should work together with other families to establish shared rules, so no parents have to struggle alone or feel guilty when their teens say they are the only one who has to endure limits. And young people can build on teen-focused efforts like the Log Off movement and Wired Human to support one another in reforming their relationship with social media and navigating online environments safely.

Others must help, too. Public health leaders should demand healthy digital environments for young people. Doctors, nurses and other clinicians should raise the issue of social media with kids and parents and guide them toward safer practices. And the federal Kids Online Health & Safety Task Force must continue its leadership in bringing together the best minds from inside and outside government to recommend changes that will make social media safer for our children.

One of the worst things for a parent is to know your children are in danger yet be unable to do anything about it. That is how parents tell me they feel when it comes to social media — helpless and alone in the face of toxic content and hidden harms. I think about Lori, a woman from Colorado who fought back tears as she told me about her teenage daughter, who took her life after being bullied on social media. Lori had been diligent, monitoring her daughter’s accounts and phone daily, but harm still found her child.

There is no seatbelt for parents to click, no helmet to snap in place, no assurance that trusted experts have investigated and ensured that these platforms are safe for our kids. There are just parents and their children, trying to figure it out on their own, pitted against some of the best product engineers and most well-resourced companies in the world.

Parents aren’t the only ones yearning for solutions. Last fall, I gathered with students to talk about mental health and loneliness. As often happens in such gatherings, they raised the issue of social media.

After they talked about what they liked about social media — a way to stay in touch with old friends, find communities of shared identity and express themselves creatively — a young woman named Tina raised her hand. “I just don’t feel good when I use social media,” she said softly, a hint of embarrassment in her voice. Her confession opened the door for her classmates. One by one, they spoke about their experiences with social media: the endless comparison with other people that shredded their self-esteem, the feeling of being addicted and unable to set limits and the difficulty having real conversations on platforms that too often fostered outrage and bullying. There was a sadness in their voices, as if they knew what was happening to them but felt powerless to change it.

As a father of a 6- and a 7-year-old who have already asked about social media, I worry about how my wife and I will know when to let them have accounts. How will we monitor their activity, given the increasingly sophisticated techniques for concealing it? How will we know if our children are being exposed to harmful content or dangerous people? It’s no wonder that when it comes to managing social media for their kids, so many parents are feeling stress and anxiety — and even shame.

It doesn’t have to be this way. Faced with high levels of car-accident-related deaths in the mid- to late 20th century, lawmakers successfully demanded seatbelts, airbags, crash testing and a host of other measures that ultimately made cars safer. This January the F.A.A. grounded about 170 planes when a door plug came off one Boeing 737 Max 9 while the plane was in the air. And the following month, a massive recall of dairy products was conducted because of a listeria contamination that claimed two lives.

Why is it that we have failed to respond to the harms of social media when they are no less urgent or widespread than those posed by unsafe cars, planes or food? These harms are not a failure of willpower and parenting; they are the consequence of unleashing powerful technology without adequate safety measures, transparency or accountability.

The moral test of any society is how well it protects its children. Students like Tina and mothers like Lori do not want to be told that change takes time, that the issue is too complicated or that the status quo is too hard to alter. We have the expertise, resources and tools to make social media safe for our kids. Now is the time to summon the will to act. Our children’s well-being is at stake.

Dr. Vivek H. Murthy is the surgeon general and vice admiral of the Public Health Service Commissioned Corps. He was also the surgeon general in the Obama administration.

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