Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions

Abstract

Despite accumulating evidence linking screen-based sedentary behaviours (i.e. screen time) with poorer health outcomes among children and youth <18 years of age, the prevalence of these behaviours continues to increase, with roughly half of children and youth exceeding the public health screen time recommendation of 2 h per day or less. The purpose of this article is to provide an overview of key research initiatives aimed at understanding the associations between screen time and health indicators including physical health, quality of life and psychosocial health. Available evidence suggests that screen time is deleteriously associated with numerous health indicators in child and youth populations, including adiposity, aerobic fitness, quality of life, self-esteem, pro-social behaviour, academic achievement, depression and anxiety. However, few longitudinal or intervention studies have been conducted, with most of these studies focusing on physical health indicators. While most studies have used self-reported assessments of screen time, the availability of more objective assessment methods presents important opportunities (e.g. more accurate and precise assessment of sedentary time and screen time) and challenges (e.g. privacy and participant burden). Novel statistical approaches such as isotemporal substitution modelling and compositional analysis, as well as studies using longitudinal and experimental methodologies, are needed to better understand the health impact of excessive screen time, and to develop strategies to minimise or reverse the negative impacts of these behaviours. The evidence to date suggests a clear need for policy aimed at minimising the hazardous health consequences associated with screen time among children and youth.

Healthy Lifestyle Behaviours Are Associated With Children’s Psychological Health: a Cross-Sectional Analysis of Data From the New South Wales Child Population Health Survey 2013-2014

“…Amounts of screen time and mental health are related (3,37), most probably bi-directionally: poorer initial mental health predicts higher screen time (and declining physical activity levels), whilst increases in anxiety are associated with increasing screen time (8,38,39). Compared to children, we identi ed that proportionally fewer adolescents met the screen time recommendations, in agreement other Australian population studies (22) and international ndings (9). This reinforces adolescence as a particularly critical time for reducing mental health related risk behaviours.…”

“…Investigations into unhealthy lifestyle behaviours have shown that they contribute to poorer health related quality of life and have a prolonged negative in uence on psychological health (2,(6)(7)(8). Increased electronic screen time is an issue of growing concern across all developed countries (9,10), due to evidence of its contribution to increased sedentary behaviour and a host of other undesirable outcomes, including poorer quality of life and behavioural and psychological di culties (11)(12)(13)(14).…”

Sedentary behavior among Spanish children and adolescents: findings from the ANIBES study

“…This so called screen-based sedentary behavior has been associated with a range of adverse health consequences [12, 13]. even independently of their impact on PA [14], such as adiposity, aerobic fitness, quality of life, self-esteem, pro-social behavior, academic achievement, depression and anxiety [15]. Other authors conclude that there is not enough data available to draw conclusions on this issue, specifically if children and adolescents are sedentary but active at the same time [16].…”

Screen-time: a new stakeholder in children and adolescent health

“…Tiene también consecuencias negativas para la salud mental, en especial problemas de inatención en los más pequeños (3), y en adolescentes (4), en los que tienen especial protagonismo las redes sociales (5). Hay suficiente información disponible que apunta a que el tiempo de consumo de pantallas se asocia de una forma negativa a mayor adiposidad, peor condición física, pero calidad de vida, menor autoestima, pero rendimiento académico y pérdida de habilidades sociales, mayor grado de ansiedad y de depresión (6). Por el contrario, la práctica regular de actividad física se asocia a un mayor bienestar y a un mejor estado de salud mental (7,8).…”