A Warning on Kids and Social Media Risks

( Erin Hooley, File / AP Photo )
Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. We are honored to have with us now right out of the gate this morning the United States Surgeon General Dr. Vivek Murthy. Just this morning, Dr. Murthy released a Surgeon General's advisory on the growing concerns about social media on young people's mental health. Now, as a spoiler alert, he does not conclude that social media is all bad for America's youth.
He sees some good in it in some cases, but he does conclude that our children have become unknowing participants in a decade's long experiment by social media companies to see what the effects actually are, and it's not okay to just let that go on as is. Let's start there with US Surgeon General Vivek Murthy. Dr. Murthy, it's always good to have you on the show. Welcome back to WNYC.
Dr. Vivek Murthy: Well, it's so good to be back, Brian. I hope you've been well.
Brian Lehrer: Thank you very much and same to you. Now, the first thing your press release on the new advisory addresses is just how pervasive social media use is among American children in the US now, and not just among teenagers, but children as young as eight years old. Can you lay some of that out for us?
Dr. Vivek Murthy: Absolutely. I'll tell you, I come at this issue of social media use in youth mental health, not just as Surgeon General or as a doctor, but as a father of two young kids who are growing up quickly and who are starting to ask about social media even though my daughter is only five years old. This has become nearly universal. 95% of teens are using social media. Two-thirds of them are using it daily. One-third say that they're using it constantly. That's an extraordinary number, but the reason that this is--
What's also important here is how much they're using it. On average, teens are using social media for three and a half hours a day. The reason that number matters so much is because we see in the data that when teens use social media for more than three hours a day, they face double the risk of depression and anxiety symptoms. Again, the average is three and a half hours. We lay out in my advisory a number of areas that we're concerned about where the data is pointing toward harmful effects.
Brian Lehrer: Although rather than just say this is damaging, you say we don't have enough evidence yet to conclude whether the current patterns of social media use are safe.
Dr. Vivek Murthy: What we do with other products that kids use like car seats, baby formula, medications, even cars, think about a 15 or 16-year-old about to start driving is, we put safety standards in place so that we know that these products are safe. What we say in the advisories having looked at all of the evidence that is publicly available and talked to subject matter experts, we cannot, in fact, conclude at this point that social media is sufficiently safe for our kids. What we do have instead is growing evidence that social media use is associated with harms.
There is more data, certainly, we need. That data has not been made available to independent researchers, they tell me, by the technology companies and to the fullest extent that it needs to be, but we know enough now to take action to protect our kids, and that's what I call for in this advisory. We can't afford to wait years more to continue to gather more data. We know enough now to know that there isn't the safety evidence that we need, and that means we've got to take steps to establish safety standards and actually implement and enforce them.
Brian Lehrer: Something you just said, should that be one of the biggest headlines we take away from your advisory that social media companies have data that they're not sharing with the public on harms to children?
Dr. Vivek Murthy: Well, what we hear from researchers all the time all across the country is that they aren't getting all the data that they need from social media companies to fully assess the impact of social media on kids. That data may tell us that the harms are greater than what we're currently seeing in the available data. It may tell us that there are certain kids who are more at risk. Understanding this is critical so that we can target our interventions appropriately.
Look, as a parent, I don't want to ever encounter a situation where I feel like there's information that's being hid from me or that's not being disclosed when it pertains to the health and well-being of my child. I think every parent has a right to know this information. I also think they should be able to rely on independent researchers to assess that data and tell them whether or not their child is at risk.
Brian Lehrer: Now, I mentioned in the intro that your advisory does not say social media is all bad for teens and even younger children. You note some specific risks like we've been talking about already but also some specific benefits that social media use can have. For example, I'm reading from your press release here, 7 out of 10 adolescent girls of color report encountering positive or identity-affirming content related to race across social media platforms at least monthly.
Number two, a majority of adolescents report that social media helps them feel more accepted. 58% like they have people who can support them through tough times. Social media can serve as a source of connection, information, and support for youth who are often marginalized such as the LGBTQ+ community and people with disabilities. That's a lot, and that's not the kind of thing we usually hear in media discussions of social media. Do you want to elaborate on any of those?
Dr. Vivek Murthy: Oh, absolutely. Well, the data does tell us that social media can have mixed benefits and risks for kids. Some kids do find that they can connect more easily with family and friends and have a place and a forum to express themselves creatively on social media and to find a community that they may not otherwise find in person. All that is very important, but we also have to balance that against the risks that have begun to emerge in the data, risks around depression and anxiety symptoms, but also risks related to body image.
Nearly half of adolescents are saying that using social media makes them feel worse about their bodies. Then consider that for a moment. We're living in a time when eating disorders, where poor self-esteem are profound challenges for so many youth. I, like all parents, want my kids to grow up with confidence, feeling good about themselves, and set up to really thrive and succeed, but for too many kids, that is not the experience they have on social media.
Let me just give you an analogy as well, Brian, which is if we had a medication that was very effective, let's say, at treating infections, but also it turned out it had side effects and had terrible effects on your kidney and your liver, we would say, "Gosh. We don't know if that should be made available to people if those risks are significant. We should either study that more or change that medication or put safeguards in place so that people are protected against that downside harm."
We have to think about this similarly, which is that the goal should be to maximize the benefits of social media while minimizing the harms, but to do that, we've got to take an intentional approach. We've got to establish actual safety standards like we do for other products that kids use, and that doesn't exist right now. Even the age limitations that companies have put in place where they say you have to be 13 years or older to use many of these platforms, even those are not well enforced because 40% of kids 8 through 12 are on social media.
Brian Lehrer: Concerns about media exposure, as I'm sure you know, go back to the printing press. Media critics of Gutenberg's era said people would become disconnected from each other because they'd be in their own worlds reading books. We know that television used to be a concern over mindless passivity. Maybe it still is, but we don't talk about it that much anymore. Now, kids simply watching TV, some people see that as the good old days. Is today's concern different in kind?
Dr. Vivek Murthy: I'm really glad you asked that question, Brian, because you're right. Whenever there's major change often introduced by different modern technologies, sometimes people get worried about what they're losing as a result of that, but there's something fundamentally different, I believe, about what's happening with social media. It has transformed our lives in a much more profound way than television and than other recent developments in technology. If you think about it this way, social media has fundamentally changed how kids see themselves, how they interact with each other, and how they perceive the world.
It's also rapidly evolving technology so much so that for many parents, it's incredibly difficult to keep up with this technology much less monitor it and manage it for your children. It's also pervasive. When I was growing up, if I wanted to turn off the information environment around me, I got up and I turned off the TV, but for a child now growing up, it's coming at them 24/7, information, posts, another content on social media, and much of that content for so many kids is not positive.
Too many of our kids are exposed to violence and sexual content online, to bullying and harassment. This is a real profound challenge. It takes a toll on the mental health and well-being of kids. Finally, just keep in mind, we are living through perhaps the worst youth mental health crisis in recent memory. We've got to look under every stone, if you will, to understand what the causes and drivers may be, and to address them.
I believe when I talk to parents and kids around the country and I look at the data that we have that social media is likely to be one of the key drivers here, and that's why we've got to act quickly. This isn't about getting rid of social media altogether for everybody. This is about making sure that we're thoughtful and intentional about protecting our kids from the harms and ensuring that they can reap the benefits.
Brian Lehrer: Listeners, if you're just joining us, we have a few more minutes with the United States Surgeon General Dr. Vivek Murthy, who just this morning has released a Surgeon General's advisory on the growing concerns about social media on young people's mental health. I want to let people know because I've been reading your other material from recently that this advisory is in the context of a larger project that you've undertaken to fight what you call a loneliness epidemic in the United States. Can you give us some of the big picture on that as it relates to this?
Dr. Vivek Murthy: Oh, I'm glad you brought that up, Brian, because this is a concern I've had for a long time but it's been growing, which is that I do believe, sadly, we are experiencing an epidemic of loneliness and isolation in America. It's not just America, many other countries are experiencing this as well. One in two adults in America report measurable levels of loneliness. The numbers, it turns out, are even greater among young people.
This matters so much, Brian, because we now understand something we perhaps didn't 10/15 years ago, which is that social disconnection, when you're lonely and you're isolated, that is actually associated with, not only worse mental health outcomes like depression, anxiety, and suicide, but also with worse physical health outcomes, including cardiovascular disease, premature death, and dementia and stroke. The bottom line is that our connection to one another is not just nice to have, our relationships are vital for our survival.
When we are disconnected with one another, it is not only bad for our individual health, but it affects societal health as well. It turns out that when communities are more connected, they're more economically prosperous. They tend to have less violence, and they're more resilient in the face of adversity like hurricanes and tornadoes. Too many people are feeling disconnected. Too many communities have actually broken down over the years because, in the last half-century, we've seen a decline in participation in faith organizations and recreational leagues and so many of the groups that brought us together.
Social media ultimately, I believe, created the hopes of building community and bringing people together. While some people have found that, far too many people have found that what used to be higher quality in-person interactions have been replaced with lower quality online interactions. There's nothing to replace in-person connection. All of us need that.
Brian Lehrer: How much do you think the pandemic isolation intersected with the good and bad of social media?
Dr. Vivek Murthy: That's important. The pandemic for many people worsened their sense of isolation and loneliness, although that was a trend that was building for many years prior to the pandemic. I would say the pandemic poured fuel on a fire that was already burning. When it comes to social media use during the pandemic, look, for many children, turning to social media was helpful to them during the early days of the pandemic when they weren't able to be in school because it kept them connected with friends and with family members, and that was positive.
We also know that when I talk to young people around the country about being back in school and what their life is like now, many of them say that they still feel like they're trying to rebuild their social skills and rebuild their connections to one another, and to do that, it's very important that we protect in-person face-to-face time. If we are primarily interacting with people online, again, it is just not the same. We don't build the same types of relationships.
While social media, again, can be mixed in terms of benefits and harms, our goal really should be to make sure that it's a tool that kids can use safely, that parents know they're supported on in terms of helping manage the use by their kids. I'll just tell you right now, Brian, that so many parents feel alone in managing this challenge. They feel like the entire burden of managing social media, as rapidly evolving and changing as it is, has been placed on their shoulders.
This is the time we've got to step up and have their backs, and that's why I'm calling for so many of the changes and actions from policymakers and technology companies that I am in this advisory.
Brian Lehrer: We'll close in a minute on the specific changes that you are calling for, but do you as a public health leader have any regrets over how much school or other aspects of kids' in-person social contact was shut down in the name of protecting people from the virus? In hindsight, was it to any degree a well-intentioned overreaction that may be resulting in public health, mental health, in particular, outcomes? Maybe not as bad as what we were all trying to prevent, which was mass death, but worse than you would've anticipated?
Dr. Vivek Murthy: Yes. This is an important question because we have to always look back on what happened after emergency responses and ask if we made the right decisions or not, and what can we learn for the future. There will likely be some pandemic at some point down the line. We need to take the lessons of today and apply it to that. Look, when the pandemic began, when schools were being shut down during that first year of the pandemic, I, like many Americans out there was watching as a parent.
I was a private citizen at that time. I was watching what was happening and I was worried for our country. I understood that the public health leaders in government at that time, and even though I wasn't part of government talking to them, my understanding was that they were likely making the best decisions they could with very limited information. If we knew then what we know now, I suspect that we would not have closed down schools as long as we did, perhaps, or as long as those who were in government did at that time.
I also recognize that they were operating with very limited information, so I think we should give them some grace with that and recognize what they were trying to do was really protect our kids. What was really important was to get our kids back to school as soon as possible. When President Biden took office, I remember one of the things that he and I had talked about, in fact, even before he assumed office, was the importance of getting kids back to school was a top priority when he started.
42% or so of kids were in school in person. When 2021 began, that number was closer to 99% by the fall of 2021. That was the right move to get kids back to school. The bottom line is, though, we've got to deal with the ongoing fallout that our kids and frankly the broader population is dealing with from COVID-19. It's not just from the shifts in school, but keep in mind that many kids lost loved ones. 160,000 plus kids lost caregivers during the pandemic. Many of them saw people they care about get sick, and their lives were turned upside down.
They're still struggling to get back a sense of stability and normalcy. That's why youth mental health is such an important issue for us to address. It's why it will continue to be the key priority that I hold as Surgeon General, and it's why issues like social media are critical because they deeply affect the mental health of our youth.
Brian Lehrer: Right. Of course, the closures were not just to protect the kids but also to protect the teachers, the parents, and the grandparents who were more at risk from serious disease. All right. You say the burden cannot simply fall to parents and children as individuals to control the negative effects of social media, so what institutions, government or corporate, should do what?
Dr. Vivek Murthy: If we think about technology companies where they can really play an important role here is number one, in designing their platforms in ways that prioritize the safety and well-being of users. Many of the platforms are designed to maximize time spent. As Surgeon General, what I care about is the health and well-being of our kids on these platforms, and that's what we should be seeking to maximize.
Technology companies can also, though, be more transparent with the data that they have that's related to health impacts so that independent researchers can assess this and help parents understand the full impact of these platforms on their children. This can't be left up to technology companies alone, and that's why I lay out a number of steps that policymakers have to take as well.
We need our lawmakers to establish safety standards to protect kids from harmful content, to also ensure that they're protected against features that would seek to manipulate them to spend excessive, unhealthy amounts of time on these platforms. We should also have standards that protect the privacy and the identity of users. Keep in mind, 6 in 10 adolescent girls have been contacted by a stranger on social media in ways that made them feel uncomfortable. We've got to be better to actually protect our kids from that kind of contact.
Finally, policymakers can require the kind of data sharing and transparency that researchers say we have been lacking for far too long. Policymakers are important here because it's not just in setting standards, but it's actually in enforcing them. The very limited rules that we've had so far just have not been adequately enforced in my mind. As a parent, what I want to know is that not only are there standards in place, but that as a parent that I'm understanding transparently what the data is telling me, how it's evolving around the risks and benefits to my kids.
We owe it to parents to provide them that. Again, Brian, I say this as a parent myself. I've got a five and six-year-old, and my five-year-old daughter came home a couple of weeks ago and she asked my wife and I if she could post a picture on social media. We were stunned. She's in preschool. We haven't talked to her about social media. Clearly, she doesn't have a social media account and she won't for a while, but this has become ubiquitous.
Kids see and encounter social media everywhere. They're thinking about it and talking about it. We can't wait to take these steps that I've outlined to make sure that these platforms are safer and to put in place the guardrails around age restrictions and safety restrictions that these platforms have needed for a long, long time.
Brian Lehrer: The next generation's first words, mama, dada, and TikTok. We will see if policymakers run with your advisory that you were releasing this morning on not just standards, but enforcement of those standards. I hear you on that point for social media companies giving the risks to youth in the United States. Listeners, we've been hearing from the US Surgeon General Dr. Vivek Murthy, who released a Surgeon General's advisory this morning on the growing concerns about social media on young people's mental health. Thank you so much for making this one of your very first stops to share it with the American people. Thank you very much.
Dr. Vivek Murthy: Well, thank you, Brian. I'm so glad to talk about this. Just for everyone to keep in mind, our kids are at a very sensitive time of development, specifically brain development, and what they're exposed to really matters during those years, so every year for our children count. It's why I'm so focused on making sure that these platforms are safe for our kids.
Brian Lehrer: Thanks, Dr. Murthy. Brian Lehrer on WNYC. Much more to come.
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