Surgeon General Advisory Warns Excessive Screen Use Is a Top Public Health Threat for Children and Adolescents
Key Insights
A new U.S. Surgeon General advisory identifies excessive screen use as one of the biggest public health issues of the 21st century, with screen exposure often beginning before a child's first birthday.
Research links heavy social media use in teenagers to increased depressive symptoms, poor sleep, low self-esteem, and body weight dissatisfaction, according to a large 2018 Lancet study.
Screen use before bedtime consistently results in shorter sleep duration and poorer sleep quality, with downstream effects on academic performance and mood, per 2016 JAMA Pediatrics research.
A new advisory from the U.S. Surgeon General, published by the Department of Health and Human Services (search), warns that excessive screen use among children and adolescents has become one of the most pressing public health challenges in the United States. The advisory highlights that screen use often begins before a child's first birthday, underscoring the urgent need for early intervention.
"The harms of screen use is one of the biggest public health issues facing our nation in the 21st century," said Dr. Stephanie Haridopolos of the U.S. Surgeon General's Office. With no currently confirmed surgeon general in the Trump administration, the advisory was brought forth as a collaborative effort by the Department of Health and Human Services (search).
Mental Health and Neurological Concerns
Research increasingly points to significant mental health consequences tied to heavy screen and social media use. A large 2018 study involving over 10,000 teenagers, published in The Lancet, found that greater social media use was associated with online harassment, poor sleep, low self-esteem, body weight dissatisfaction, and increased depressive symptoms.
Dr. P. Travis Harker, chief medical officer at Appledore Medical Group (search), likened the effects of screens to addictive behaviors. "They hit the same reward centers that gambling does in our brains," Harker said. "It triggers that same addictive potential in our brains." He noted that 95% of teenagers report being on social media, a phenomenon whose long-term effects remain unknown.
Emerging evidence also suggests that frequent social media use may produce distinct changes in the amygdala, the brain region responsible for regulating emotions, indicating that the developing adolescent brain may be particularly susceptible to external influences like social media.
Sleep Disruption and Physical Health
Sleep disruption represents one of the clearest biological concerns documented in the literature. Research published in JAMA Pediatrics in 2016 found that children who use screens before bedtime consistently experience shorter sleep duration and poorer sleep quality. The advisory notes that poor sleep is associated with worse academic performance, mood instability, and impaired concentration.
Beyond sleep, screens are also affecting children's physical health by contributing to a lack of physical activity, experts said. Jodie Lubarsky, vice president of clinical operations for youth and family services at Seacoast Mental Health Center (search), described the compulsive nature of screen use: "You see them sit it down, and sometimes close to 30, 60 to 90 seconds later, they're already picking it back up and looking at it."
Displacement of Developmental Activities
Increased screen use can result in displacement, where time spent on digital media curtails time spent in social interaction, physical activity, reading, and enjoying outdoor nature. Research from 2023 shows that increased screen time can reduce the amount and quality of interactions between children and their caregivers, which may stunt future social and emotional growth.
"We're giving kids and adolescents these devices and believing and setting these expectations that they have the ability to manage it and monitor it on their own," Lubarsky said. "But the reality is they really don't."
Acknowledged Benefits and a Nuanced Picture
Despite the risks, research also points to tangible benefits. Educational media can support learning, literacy, and problem-solving. Interactive educational programs on screens may improve vocabulary acquisition and student engagement, and games can improve problem-solving skills for children.
Online communities may help adolescents who feel socially isolated, including children with disabilities, chronic illnesses, or mental health struggles. Moderate screen use can enhance social connection and allow socially anxious individuals to practice communication skills in a comfortable environment.
The advisory emphasizes that there is no "one size fits all" approach, as screen use exists on a spectrum. Educational videos differ dramatically from endless scrolling on social media platforms.
Recommendations and Family Strategies
The surgeon general advisory calls for delaying screen use from an early age, discussing screen use expectations between caregivers and children, creating regular screen-free times during the day, and providing alternatives so screen time is not the default when children are bored.
Some families are already implementing creative solutions. Katherine Haley, a mother of two sons, described using a "house phone" — an extra cellphone that lives in a drawer when not in use — and maintaining an open dialogue with her children about their device activities. "It's easier to open it back up in increments, as opposed to having your child get ahead of you," she said.
Jeff Laferriere, executive director of Camp Me-Ti-Na, emphasized the value of screen-free environments, noting that all Granite YMCA (search) summer camps are screen-free. "These really are the years where making that connection and learning those skills is just important," he said.
Lubarsky offered a straightforward prescription: "We have to make that deliberate act to shut it off, put it away and go do something that actually fills our bucket and makes us feel better."