1
Introduction
There are over 1.3 billion young people between ages 10 and 19 in the world today, approximately 1.8 billion between ages 10 and 24, making up the largest generation of youth to have ever lived (Bustreo et al., 2022; UNICEF, 2022). In much of the world, this generation has grown up with the internet influencing their relationships, the way they learn, and how they experience life milestones. A recent national survey of teens1 in the United States found that 95 percent have access to a smartphone, and 97 percent use the internet daily (Vogels et al., 2022). This marks a steady increase in internet and device use since the early 2000s and a major cultural shift (Lenhart, 2009). Excitement about the immense potential of digital technologies for education, health, and entertainment is increasingly coupled with concern about the psychological and intellectual consequences of constant connectedness, particularly during developmentally sensitive windows.
Against this backdrop of ambivalence about the role of social media in the lives of young people emerged a series of revelations in fall 2021 from Facebook whistleblower Frances Haugen. Internal documents shared with the Wall Street Journal, cited internal research on the platform’s potential for harm. While reporting that a majority of users found the networking site Instagram to be either helpful or of no influence on the way they man-
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1 Aged 13 to 17 years.
age mental health problems, Facebook2 researchers frankly admitted, “We make body image issues worse for one in three teen girls” (WSJ, 2021a, p. 14). Of similar concern was the company’s estimate that 12.5 percent of Facebook users, roughly 360 million people, report that they feel powerless to control their interaction with the platform, checking their accounts constantly, to the detriment of their health, work, and relationships (Wells et al., 2021).
The methods and validity of the company research reported in the Haugen papers cannot be verified, but their publication marked a watershed for Facebook and the social media industry (Duffy, 2021; Horwitz, 2021; Lima, 2021). At the center of this crisis was the perception that Facebook was willing to overlook the risks of their product and publicly misrepresent their internal findings if doing so advanced the company’s growth or market standing (Dwoskin et al., 2021; Lima, 2021).
Social comparison is nothing new, and neither are compulsive behaviors. But the scale to which digital technologies facilitate them is. Embarrassment and rejection are worse when they are broadcast to an almost limitless audience and memorialized in an online record. Escape from the psychological cues that encourage toxic behavior becomes logistically impossible when the trigger follows the user everywhere, all the time, in a handheld device.
An interest in the relation between youth mental health and social networking were at the root of Facebook’s market research on teen mental health. This research, released with the Frances Haugen papers, found that 82 percent of teenage users had emotional problems in the previous month (WSJ, 2021b). This result is broadly consistent with a body of epidemiological literature describing a “mental health crisis” among young people (CDC, 2022). Over the last decade, the Centers for Disease Prevention and Control’s (CDC’s) Youth Risk Behavior Survey has found a steadily growing percentage of high school students reporting persistent sadness or hopelessness, with 22 percent considering suicide over the same time (CDC, 2023). As Figures 1-1 and 1-2 indicate, these increases are more pronounced among girls.
In almost every indicator measured by the Youth Risk Behavior Survey, LGBQ3 teens are worse off than heterosexual teens (see Figure 1-3). Compared with their heterosexual peers, LGBQ students were more likely to misuse prescription opioids, have unstable housing, be bullied (online or at school), and forced to have sex (CDC, 2023). These data suggest that members of sexual and gender minorities face serious risks, which,
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2 Facebook was rebranded as Meta not long after these papers were leaked (Frenkel et al., 2022).
3 Questions about transgender identity were not part of the survey.
SOURCE: CDC, 2023.
given that there are roughly 2 million teenagers in the United States who identify as lesbian, gay, bisexual, or transgender, could translate to hundreds of thousands of young people in danger of trauma every year (Conron, 2020). Yet strategies to help these teens, or anyone at elevated risk by virtue of their relative isolation, often hinge on the availability of online support. Social media can provide support and connection for young people who live in communities where sexual and gender diversity are not accepted; it can also serve as a buffer against stigma and loneliness that drive mental health problems (Berger et al., 2022; Jenzen, 2022; Kaniuka et al., 2019). For these reasons, the Trevor Project, a suicide prevention organization for LGBTQ+ youth, recommended supportive
online communities as a counter to stress, especially the increased stress of the COVID-19 pandemic (Green et al., 2020).
Discerning the relative supportiveness of an online environment remains difficult, however. Much depends on the users’ psychosocial makeup, patterns of their online behavior, and their reasons for turning to the online world in the first place (Kuss and Griffiths, 2011; Nesi, 2020). During typical adolescent development, heightened sensitivity to peer evaluation can make the experience of online social exclusion or conflict, a central part of social media use, more intense (Nesi, 2020). Social media can also expose users to content related to disordered eating, self-harm, and suicide, even as increasingly sophisticated algorithms are able to screen for mental health problems from users’ profiles (Guntuku et al., 2017; Nesi, 2020). The use of social media to mitigate mental health problems may depend on the extent to which these media have contributed to them in the first place.
Teens’ use of social networking is a commonly cited cause for the deterioration in their mental health, but it is by no means the only one (Haidt and Allen, 2020; Turner, 2023; Twenge, 2019). Gun violence, climate change, parental attitudes, social unrest, poverty, inequity, and isolation have all been proposed as explanations, as has some combination of multiple factors (Abrams, 2022; Rosin, 2014; Schiffman, 2022). As Derek Thompson observed in The Atlantic,
these explanations aren’t equally valid, and some of them might be purely wrong. But the sheer number of theories reflects the complexity of mental-health challenges and suggests that, perhaps, nobody knows for sure what’s going on. (Thompson, 2023)
This confusion extends even to assessments of whether youth mental health is in a state of crisis. Much of the concern about problems in young people comes from an analysis of data from the last decade or two (Morgan et al., 2017; Sumner et al., 2021). Data on suicide, the most extreme consequence of psychological pain, indicate that the apparent spike in problems over the last 15 years may be more an example of long-term cyclicality, following a relative low point in the 1990s and 2000s (see Figure 1-4) (Levitz, 2023; Rinehart and Barkley, 2023). It is also worth noting that suicide mortality has increased in almost all groups over the last 20 years, this is not problem unique to adolescents (Garnett and Curtin, 2023). To be sure, any incidence of suicide, especially among young people, is too much. At the same time, an overemphasis on the recent past could lead an observer to a mistaken emphasis on recent explanations (e.g., teen suicide has risen with use of smartphones and social media, therefore they are related). To better understand this problem, it is nec-
SOURCE: Created with data from the Centers for Disease Control and Prevention WONDER and WISQARS databases.
a This figure was replaced after the report was released with a figure that standardizes data points between 1999 and 2020 to those for 15 to 19 year-olds.”
essary to look beyond seemingly obvious explanations and identify the young people in need of help.
Nevertheless, a suspicion that social media is at the root of young people’s mental health problems has motivated state legislatures around the country to curb adolescent use of social media and take action against the companies that profit from it. In March 2023, the governor of Utah signed a bill limiting the use of social networking and gaming sites by anyone under 18; in California, recent legislation prohibits tech companies from using minors’ personal information in ways that could harm them (Metz and Ortutay, 2023; Willon, 2022). With similar legislation proposed in other states and encouraged in President Biden’s 2023 State of the Union address, there is a timely and pressing need for more clarity as to the precise harms and benefits social media pose to young people (Singer, 2023).
THE CHARGE TO THE COMMITTEE
A concern with disentangling the benefits and the harms of social media use is at the root of the charge to this committee set out by the Democracy Fund, the Ford Foundation, the William and Flora Hewlett Foundation, Luminate Projects Limited, the John D. and Catherine T. MacArthur Foundation, and the Open Society Foundations. The statement of task, shown in Box 1-1, was developed through a consultative process including representatives of all the sponsoring organizations. In addition to asking questions about the broad effects of social media on physical and mental health and well-being, the committee was asked to investigate the relative risks and benefits of various forms of online media and the consequences of media use during childhood and adolescence. The committee was also asked to identify a research agenda that might help clarify the causal pathway between social media use and various health indicators. The sponsors asked the National Academies of Sciences, Engineering, and Medicine to convene a consensus committee to answer these questions; committee members had expertise in cognitive science, computational science, economics, education, epidemiology, law, media science, mental health, network science, neuroscience, pediatrics, psychology, social media, and technology. More information about the committee members answering this charge can be found in Appendix A.
The Committee’s Approach to Its Charge
This committee had six meetings over 12 days between January and September of 2023 (see agendas for public meetings in Appendix B). In closed sessions, committee members deliberated on the material presented in public sessions and the literature reviewed in this report. Subgroups of the committee had regular calls to develop recommendations and consider the arguments presented. Members of the public submitted various comments and reading material for the committee’s review; this material is available on request from the National Academies Public Records Office.
In defining the scope of this report, the committee first struggled in classifying the media in question. Social media platforms vary widely, and a definition that calls out specific platforms or apps risks quickly becoming irrelevant; social networking platforms wax and wane in popularity, especially among young people. For this reason, the committee relies on a definition adapted from the American Psychological Association: Social media refers to “interactive technologies that facilitate the creation and sharing of information, ideas, interests, and other forms of expression through virtual communities and networks” (APA, 2023). This can
include, as the American Academy of Pediatrics and other scholars have highlighted, social networking sites, gaming sites,4 virtual worlds, video sharing sites, and blogs (Aichner et al., 2021; O’Keeffe et al., 2011). Social networking sites are a subclass of social media characterized by user profiles, the listing of connections, and the ability to view profile information among connections; this subclass has been of particular interest to researchers (Bayer et al., 2020). The term “digital media” is sometimes used as a parent category to capture all media consumed through screens in recognition of the fact that lines between various forms of digital and interactive media are increasingly blurred (Chassiakos et al., 2016).
More important to this report than any particular definition of social media is a concept described in the computing literature as affordances, referring to what a user can do with a thing, in this case with a website, app, or video game (Soegaard, n.d.). Affordances include the capacity for public posting, running counts of feedback on posts, and communicating privately with friends or strangers; these topics are discussed more in Chapter 2. A discussion of social media that does not rely heavily on the analysis of affordances risks an overemphasis on specific applications and an underemphasis on the transferable mechanisms at play (Treem and Leonardi, 2012). This shortsightedness can in turn hold back generaliz-ability and obscure the relationship between technology and behavior (Treem and Leonardi, 2012). For this reason, the committee defines social media broadly, with an emphasis on affordances, including the affordances that allow for interaction with friends or strangers.
The committee recognizes that in a discussion of social media it can be difficult to separate the platform from the corporation that controls it. Some media that started out as apps or websites are now synonymous with a much larger infrastructure, sometimes born of the stitching together of multiple different media into a hybrid. A profile on a dating site, for example, may pull data from another networking site, posing challenges to researchers who aim to study it. The amalgamation of multiple platforms can also pose concerns for society, as when well-known companies acquire smaller ones, sometimes competitors. The parent company’s branding of subsidiaries can in turn affect perception of the similarities or differences among them (Bayer et al., 2020). With this in mind, this report refers to specific platforms only as examples and makes a distinction when necessary between a platform and its parent company.
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4 In this report, video games are included in so much as they have affordances for social media; a larger literature on video games, especially the effects of violent games, is not included. Readers interested in large reviews of gaming can consult the 2019 APA Task Force Report on Violent Video Games.
The Committee’s View of Health
The committee’s understanding of health is equally important to this report as its understanding of social media. Throughout its deliberations and review of literature, the committee found the research and public discussion linking social media to health was disproportionately, sometimes exclusively, concentrated on mental health outcomes. This is an understandable consequence of the nature of the social media exposure; it is reasonable to wonder, even if constant social comparison or public feedback has psychological consequences, if the same would influence physical health in the same immediate, observable way. Chapter 4 explains how vastly more research has been done linking social media to mental health outcomes than physical ones, with the possible exception of sleep disruptions. The discussion in this report and the literature reviewed reflect the slant in this discussion.
In any case, the committee members were not interested in drawing artificial distinctions between mental and physical health. For readers curious as to why this report refers to health broadly even when citing specifically psychological aspects of well-being, we cite the World Health Organization’s (WHO’s) definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2023a). The organization’s explanation continues, “there is no health without mental health” (WHO, 2023b). Simply put, mental health is health and psychological outcomes are as crucial to population well-being as cardiovascular ones.
At the same time, the committee found it necessary to put logistical guardrails on its conception of a health outcome, especially as reviewed in chapters 3 and 4. Many of the consequences of social media use and the internet in general have a social and political dimension that one could link to mental health. This report discusses the potential for social media to expose young people to fringe political ideas, misogynist or racist views, and other forms of harassment. It also considers the delicate relationship between user privacy and social protection at the center of this problem. This discussion is, for the most part, complementary to the committee’s review of the health literature and more related to the committee’s charge to suggest a way to maximize benefits and minimize harms associated with social media.
The Inclusion of Lived Experience
In answering its charge, the committee was also sensitive to the importance of understanding the adolescent experience of social media from the people living it. To this end, a call for nominations was posted
to the study website asking for young people aged 13 to 18 years to share their experience of social media and gaming with the committee. Eleven participants were chosen as a purposive sample that ensured geographic diversity and a range of ages. Participants from across the United States5 met three times on Zoom to inform the committee’s deliberations. Their input served as a sounding board for the recommendations in this report and a check on the validity of the committee’s deliberations.
A Comment on Age
In reviewing their charge, the committee members and representatives of the sponsoring organizations discussed the task’s reference to both adolescents and children and its emphasis on the 13- to 18-year-old age range. On one hand, this age group may be seen to be at heightened risk, partly on the basis of a legal technicality: The Children’s Online Privacy Protection Act (COPPA) restricts the personal information that tech companies can knowingly collect and the services they can provide to children younger than 13.6 For this reason, technology companies, at least officially, know relatively little about their youngest users (Fowler, 2022; Hunter, 2022; Moyer, 2022). The age restriction reverberates in a relative scarcity of research on social media use in late childhood or early adolescence (Charmaraman et al., 2022). Most importantly, the COPPA age maximum was the result of a political compromise, informed by older rules regulating children’s television (Montgomery, 2023). Ages 13 to 18 do not represent a clear developmental stage, nor are these ages necessarily a common grouping for research.
The sponsor representatives clarified that their interest was on young people broadly with a transitional cutoff around age 18, giving the committee some leeway in its determination of the key ages to consider (NASEM, 2023). Recognizing that experiences at age 13 are influenced, even partially predetermined, by experiences earlier in childhood, the committee chose to avoid an overly strict interpretation of the age range cited in its charge. While time and feasibility prevented the committee from analyzing the online well-being of young children or adults in their twenties, this report considers adolescence and late childhood broadly, presenting evidence relating to and strategies intended for children as well as teenagers.
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5 Southern California, Illinois, Kansas, New York, south Texas, Virginia, Wisconsin.
6 Children’s Online Privacy Protection Rule, 16 C.F.R § 312.4 (2013).
The Organization of This Report
In answering the charge set out in Box 1-1, the committee strove for a thorough and accessible analysis of how social media work and how they influence young users. To this end, Chapter 2 provides an assessment of how social media work, focusing on the common advertising and consumer retention strategies as well as the platform affordances that affect users’ experience with particular emphasis on how these affordances interact with adolescence. The next two chapters discuss how social media affect well-being and review recent evidence on the benefits and harms associated with digital media use. Chapter 5 considers how changes to the design of social media might improve transparency and public confidence in the platforms. Chapter 6 sets out training and educational strategies to improve digital literacy among young people; Chapter 7 presents an analysis of the specific problem of digital harassment and abuse. The last chapter highlights bottlenecks that have created gaps in the research linking social media use to well-being and sets out a list of pressing research priorities and actions that might facilitate better research on social media.
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