Digital media health risks warrant global action to protect young people, experts argue

by Lancet

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The way digital technologies are currently built and governed creates real risks to health worldwide, alongside genuine benefits, according to a new three-paper series authored by 13 global experts and published in The Lancet. The authors call for coordinated governance of digital systems, with the health and online safety of children and young people made an immediate global policy priority.

"Use of digital media is now woven into the fabric of childhood and life as a young adult. Governments have let technology companies write their own rules, leading to business models built to capture attention and collect data, with health treated as an afterthought," says series chair professor Ilona Kickbusch, Digital Transformations for Health Lab (DTH-Lab) (Switzerland).

"The evidence linking problematic digital media use to poorer mental health, sleep and physical activity, although not conclusive, justifies coordinated, global action. With the right governance, a healthier digital world for young people is possible, one that allows them to benefit from online opportunities without substantial risk of harm to health."

Evidence of digital harms justifies immediate public health action

Digital media include the content people watch, make or share online. They span the content itself, the platform it's delivered through and the device used to access it.

A new umbrella review (a review of published reviews) for the series, covering 9 million people under 25 across 121 reviews, finds consistent associations between problematic digital media use (defined by the series as addiction-like patterns of digital media use, rather than by time spent online) and a range of adverse health outcomes for children, adolescents and young adults. Problematic digital media use is linked to a higher risk of harm to health, including common mental health problems, sleep problems and reduced physical activity.

Some beneficial health links are also identified in the review, including an association between moderate digital media use and higher well-being, and between active video game use and both higher well-being and healthier lifestyles.

The authors caution that the certainty of the findings for both harms and benefits is low: "The associations between problematic digital media use and health harms identified in our review are modest in size and rest on low-certainty evidence that cannot establish cause and effect. Meanwhile, the most valuable data on how these platforms actually affect users are hidden within technology companies, limiting independent scrutiny and slowing scientific progress," says series author Louise Holly, DTH-Lab (U.K.).

"A key recommendation of our series is that governments should require technology companies to share data on how their features affect users' health with vetted public-interest researchers and provide the legal and technical infrastructure to make that possible."

To illustrate the potential harm at a population level of high rates of digital media use combined with even a small increased risk for individuals, the authors estimated that spending more than two hours a day on screens could be associated with around 2.8 million healthy years of life lost to depression and 240,000 to obesity worldwide each year. However, they caution that these estimates should be interpreted carefully.

Author Dr. Falk Müller-Riemenschneider, National University of Singapore, says, "Our global projections of how many healthy years could be lost to depression and obesity linked to excessive screen time are intended to be illustrative of the possible scale of harm. They should not be taken as an accurate measurement of harm as, although they are based on the best available research, the certainty of the evidence is low. More research is needed to provide accurate estimates of health impacts at the population level."

Business models, design choices and weak governance

The series argues that digital media use today is predominantly shaped by large, international technology companies that governments have allowed to self-regulate for decades, producing a digital environment where commercial growth is favored over health.

"Most digital platforms are designed by companies to capture attention and collect data, not to protect health: features such as infinite scroll, autoplay and personalized recommendation feeds are deliberate design choices, not simply a matter of individual self-control," says author Dr. Jay Shaw, University of Toronto (Canada). "We need much more research into how these specific design choices in digital media influence the way people use the technology, instead of only investigating the impact of how long people spend online."

The authors argue that technology companies are drawing on a "corporate defense playbook" to delay, weaken or shape regulation in response to evidence that their products may harm health.

"Technology companies are borrowing a playbook well known from tobacco and fossil fuels: manufacture doubt, discredit critics, frame regulation as a threat to freedom. A public health approach counters this by looking at what the evidence suggests about harm across the whole population, not just what any single case can tell us," says author professor Barbara Prainsack, University of Vienna (Austria).

"Seen that way, good regulation isn't the enemy of innovation—it's a driver of good innovation, channeling it toward safety and trust. And when regulation is missing, it doesn't mean that a technology is ungoverned; it just means that companies set the rules instead of public policy."

No single measure is enough

The series says that single measures, such as age limits, are not enough on their own to tackle the risk of digital harms to health. Instead, the authors call for wide-ranging, coordinated policy action at the company, national and global levels, including:

• Requirements for technology companies to assess new products or features for harm before releasing them, and to share data on how their features affect users' health with vetted public-interest researchers.
• A global governance treaty through WHO to set baseline standards to prevent weak regulation in one country from undermining progress elsewhere.
• A dedicated international body to monitor AI harms to children and young people.

The series also highlights how litigation is emerging as a route to hold technology companies accountable for harms to health.

Kickbusch says, "Legal action can do something regulation often cannot: compel companies to disclose internal documents and shift the public conversation about who is responsible for harm. However, litigation is not a substitute for regulation and should be considered as one route to accountability among several, not the answer on its own."

The series had input from a Youth Advisory Group of six young adults ages 23–30 who discussed with the authors what the research couldn't identify about lived experience.

Youth Advisory Group member Dr. Salman Fitrat Khan (India) says, "The health risks and harms associated with digital systems are preventable. With better governance and by empowering citizens—especially young people—to co-shape digital systems around them, the online world can give us connection, information and opportunities without putting our health at risk. Governments shouldn't wait for 'perfect' evidence before acting for our generation and the ones coming after us."

Publication details

The digital determinants of health: a new era for global public health, The Lancet (2026). DOI: 10.1016/S0140-6736(26)01292-4

Journal information: The Lancet

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Preventive medicineChildren's healthPsychology & Mental healthPsychiatryPediatricsHealthy living Provided by Lancet Who's behind this story?

Gaby Clark

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