Digital culture and child and youth well-being: Position statement by the Council of Chief Medical Officers of Health

On this page

• Summary
• Statement
• Concerning trends
• Harmful content and interactions
• Rapid change and uncertainty
• Learning from the past
• Mitigating harms through multi-sectoral action
• Footnotes
• References

Summary

This statement highlights growing evidence that today's digital culture, including smartphones, social media, and algorithm-driven platforms, may affect the health and well-being of children and youth. While digital technologies offer important benefits, they also pose emerging risks.

Evidence points to concerning trends across childhood and adolescence, including impacts on early development, sleep, mental health, and exposure to harmful content. As digital technologies continue to evolve rapidly, and as evidence continues to emerge, we support a precautionary public health approach. This statement calls for shared responsibility and coordinated action across governments, industry, health systems, schools, communities, and families to reduce harm, create safer digital environments, and support healthy norms for children and youth.

Statement

In recent years, a growing body of research suggests that the extensive use of smartphones, social media, and other online platforms can affect the health of young people in harmful ways. As the Council of Chief Medical Officers of Health, we seek to raise awareness across Canada and mobilize multi-sectoral action by policy makers on this emerging public health issue.^{Footnote 1Footnote 2} In doing so, we also affirm children's rights and inherent Indigenous rights in digital spaces.

We use the term digital culture to define the relationship between people and the use of technology. Given the rapidly evolving nature (e.g., artificial intelligence) of digital culture and its deep integration into everyday life, it is necessary to continuously assess the effects and take proactive steps to protect children and youth from harm.

We acknowledge the many benefits that digital culture provides. Over the past twenty years communication has been transformed, efficiencies have been created, and, for most people, digital devices are an essential tool for daily living. Importantly, online platforms can provide an avenue for advocacy, solidarity, and belonging, especially for groups historically underserved and underrepresented.

We also recognize that the impacts of digital culture, both positive and negative, are shaped by many factors including quantity and quality of the screentime, and the degree to which daily activities such as physical activity, sleep, nutrition, and meaningful connection are disrupted. We further emphasize that though the impacts are shaped by individual behaviours, the impacts are also dependent on the broader systems influencing behaviors such as platform design, algorithmic targeting, data practices, and commercialization.

The digital landscape and related evidence on the health impacts are evolving. We acknowledge uncertainty and much of the existing data draws on associations rather than cause and effect relationships. Yet the available evidence signals that harm is likely. Several countries, including Australia and many European countries, are already taking action. As stated in the 2026 U.S. Surgeon General's Warning on the Harms of Screen Use, "When taking all the evidence together there is sufficient evidence of potential harms, suggesting we as a nation should take concrete steps to reduce them. Our children do not have the luxury of waiting until research is exhaustive and completely encompassing". Given the uncertainty and the potential for significant consequences, we support this precautionary lens.

Learn more:

• Digital culture (Digital Sociology)
• Social media ban (UNICEF Australia)
• Children's rights in the digital environment (United Nations)
• Social media ban for youth: What European countries are planning (digitec.ch)
• U.S. Surgeon General's Warning on the Harms of Screen Use: An Advisory and Toolkit on How to Protect Children and Adolescents (PDF)

Concerning trends

Early years

Although preschool children are less likely to be online than older children, the widespread availability and portability of digital devices have made screen exposure more accessible than ever. A 2022 position statement by the Canadian Pediatric Society (CPS) reviewed the health trends associated with screentime in this age group. Key findings include that high exposure to screentime is consistently correlated with language and vocabulary delay, and may negatively impact focused attention, working memory, impulse control, and self-regulation. Screentime has been associated with reduced performance in fundamental motor skills and lower manual dexterity, increased adiposity, and an increase in myopia (near sightedness), especially when the screentime replaces outdoor time. Evidence is also growing that screentime may be displacing sleep, and that the volume and nature of screentime alter sleep patterns, which in turn may impact child development and family function.

Relatedly, the CPS also draws attention to the concept of 'technoference', a term describing how caregiver distraction by technology can negatively impact child behavior. A synthesis from the Institut National de Santé Publique du Québec (INSPQ) further describes how technoference may result in reduced parental supervision in public places, less responsiveness to children's signals, and reduced learning support behaviors such as verbalization during play.

Learn more:

• Technoference: Parent distraction with technology and associations with child behavior problems (Wiley Online Library)
• Screen time and preschool children: Promoting health and development in a digital world (position statement from the Canadian Paediatric Society)
• Usage des écrans par les parents en présence de leur enfant de 0 à 6 ans : Les effets sur les pratiques parentales (French only, PDF, Institut National de Santé Publique du Québec)

Older children and youth

Balancing the benefits and risks

Concerns evolve for older children and youth as personal digital devices become widespread and highly valued, and as youth have increased autonomy. About 50% of children are carrying a smartphone by age 11 and the recently released HBSC 2022 National Report ("The Health of Young People in Canada: Focus on Mental Health") describes that 39% to 54% of Canadian students in grade 9 to 10 report online contact "almost all the time throughout the day". The CPS 2019 (reaffirmed 2025) position statement on promoting healthy screen use in school-aged children and adolescents outlines how moderate use can foster social and cognitive development, including friendship quality, sense of validation, and social connection. Yet they also point out that excessive use is linked to a range of negative associations including depression and anxiety, behavioral problems, reduced physical activity, disordered eating, sleep disruption, and reduced family connectedness.

Such mental health impacts are a growing concern. A study published by the Public Health Agency of Canada (PHAC) similarly found that the likelihood of Canadian youth reporting positive mental health indicators decreased as screentime increased. Likewise, a complex relationship between digital technology use and youth mental health and wellbeing was found in the World Health Organization (WHO) European Region policy brief suggesting that social media and technology pose a credible risk to young people.

Learn more:

• At what age should my child get a smartphone? (Centre for Healthy Screen Use)
• Original quantitative research: Recreational screen time and mental health among Canadian children and youth
• Health of young people in Canada: Focus on mental health (findings from the 2022 Health Behaviour in School-aged Children Study)
• Addressing the Digital Determinants of Youth Mental Health and Well-Being: Policy Brief (PDF, World Health Organization: European Region)
• Digital media: Promoting healthy screen use in school-aged children and adolescents (position statement by the Canadian Paediatric Society)

Problematic social media use

A subset of adolescents will exhibit addiction-like patterns of behavior in relation to social media. This is commonly referred to as problematic social media use, which describes those who have difficulty controlling their social media compulsions, feel distressed when their use is restricted, and are preoccupied with thoughts of social media use when not online. According to the HBSC 2022 National Report the prevalence of problematic social media use in grades 6 to 8 is 7% of cisgender boys, 12% of cisgender girls, and 21% of transgender and gender-diverse (TGD) youth. By grades 9 to 10, the prevalence was 7% for cisgender boys, 15% for cisgender girls, and 9% for TGD youth. Problematic social media use is further associated with psychological symptoms including depression, anxiety, inattention, irritability and hyperactivity, as well as physical symptoms including headaches, dizziness, backaches, stomach aches, and neck and shoulder pain.

Learn more:

• Problematic social media use: Associations with health complaints among adolescents (PDF, EpiCentro)
• Problematic social media use in adolescents and young adults: Systematic review and meta-analysis (JMIR Mental Health)
• Health of young people in Canada: Focus on mental health (findings from the 2022 Health Behaviour in School-aged Children Study)
• A Focus on Adolescent Social Media Use and Gaming in Europe, Central Asia and Canada: Health Behaviour in School-aged Children International Report from the 2021/2022 Survey (PDF, World Health Organization: European Region)

Harmful content and interactions

Children and youth may encounter a range of harmful or inappropriate content online such as exploitative marketing of unhealthy food, early exposure to gambling and pornography, and the promotion and sale of illegal substances. Unrealistic and harmful ideas about body image and masculinity are commonly promoted. Preliminary evidence links social media and eating disorders, with emerging evidence also pointing to associations with traditional risk-taking behaviours such as substance use and risky sexual activity, as well as new online risk-taking behaviours, such as social media challenges.

The online environment can rapidly spread and amplify false and inaccurate information, and can facilitate cyberbullying, as well as more extreme forms of harmful or hateful interactions such as gender-based violence, racism (including Indigenous specific racism), and sexual exploitation.

While exposure to harmful content is not new, sophisticated algorithms and the constant accessibility of personal devices allows platforms to target young people in persistent and tailored ways, and, in doing so, may perpetuate detrimental narratives.

Learn more:

• Together we can stop cyberbullying
• Technology-facilitated gender-based violence
• What We Heard report: Indigenous Online Safety
• Online hate and aggression among young people in Canada
• What is the manosphere and why should we care? (UN Women: Europe and Central Asia)
• Social media use and risky behaviors in adolescents: A meta-analysis (National Library of Medicine)
• Impact of pornography consumption on children and adolescents: A trauma-informed approach (Frontiers)
• Online child sexual exploitation: Criminal justice outcomes of police-reported incidents in Canada, 2014 to 2021
• Protecting Canada's youth from the risks of exposure to gambling advertising (Canadian Medical Association Journal)
• Monitoring and restricting digital marketing of unhealthy products to children and adolescents (World Health Organization)
• The spread of misinformation: A multivariate analysis of the relationship between individual characteristics and fact-checking behaviours of Canadians
• Epidemiological alert: Intoxications due to chemical substances associated with social media challenges: 18 December 2024 (Pan American Health Organization)
• The association between social comparison in social media, body image concerns and eating disorder symptoms: A systematic review and meta-analysis (Science Direct)
• Understanding and preventing the advertisement and sale of illicit drugs to young people through social media: A multidisciplinary scoping review (National Library of Medicine)
• The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people (Global Public Health)
• Algorithms, addiction, and adolescent mental health: An interdisciplinary study to inform state-level policy action to protect youth from the dangers of social media (Cambridge University Press)

Rapid change and uncertainty

The rapid and ongoing evolution of digital culture presents a unique challenge: the ability to assess health impacts lags behind the pace of technological change. Understanding the impacts of digital culture on attention, interpersonal relationships, communication skills, mental health, and other aspects of well-being is essential. More comprehensive research is necessary to explore both positive and negative impacts over time. Of particular concern is the emergence of artificial intelligence, which introduces a new layer of unknown risks for children and youth. A precautionary approach is warranted.

Learning from the past

Expanding on a metaphor first used by the American Academy of Pediatrics, motor vehicle safety offers a useful analogy for addressing the challenges of digital culture. Motor vehicles have brought profound benefits but also introduced significant risks. To minimize harm there were comprehensive and ongoing changes to modify the vehicular design (seat belts, air bags, etc.), the environment (road structure, bike lanes, etc.), and the social norms of driver behavior (driver's education, speed limits, minimum ages, etc.). These interventions did not occur by placing the responsibility solely on the driver to make better choices but instead relied on a broad comprehensive approach that leveraged both government policy and manufacturer led improvements in response to consumer pressure.

Addressing the challenges of digital culture demands a similarly comprehensive approach. This includes implementing policy and regulatory measures to reduce harms from the online environment, redesign technologies to better protect young users, and reshape social norms around digital behavior. The responsibility should no longer rest solely on young people and families.

Learn more:

• Achievements in public health, 1900-1999 motor-vehicle safety: A twentieth century public health achievement (U.S. Centers for Disease Control and Prevention)
• Putting forward a new narrative for adolescent media: The American Academy of Pediatrics Center of Excellence on Social Media and Youth Mental Health (Journal of Adolescent Health)

Mitigating harms through multi-sectoral action

We draw on the WHO European region policy brief to inform policy actions aimed at improving technology design and creating safer online environments, and we adopt a health promotion approach aimed at shifting norms through increasing awareness, policy, and strengthening healthy environments where children and youth live, learn, work, and play.

Learn more:

• Addressing the Digital Determinants of Youth Mental Health and Well-Being: Policy Brief (PDF, World Health Organization: European Region)

What the federal government can do

• Safeguard children and youth in digital spaces by exploring and implementing policy options that:
  • restrict or remove addictive design features and design tactics that target children and youth
  • moderate harmful content
  • require strict age restrictions and verification systems
  • promote or mandate the adoption of parental controls tools
• Promote public awareness and education, conduct child and youth-inclusive public consultation, facilitate independent research, and engage partners, including youth, to collaborate on solutions.

What provincial governments can do

• Policy innovation such as cellphone policies for schools and intimate image protection legislation.
• Curriculum development aimed at developing digital literacy, responsible digital engagement, and critical thinking.
• Promote healthy technology use aimed at youth and families.
• Enhance funding to strengthen prevention, education and treatment interventions for youth and families impacted by digital harms such as problematic social media use.
• Enable municipalities to robustly support active, screen free recreational opportunities for children and youth.

Learn more:

• Regulation Respecting the Rules of Conduct in Elementary and Secondary Schools (Government of Quebec)

What health systems can do

• Equip providers with clinical tools and resources for screening and interventions related to health impacts of digital harms.
• Build digital literacy and digital 'checks' into parenting and family/baby health check programs as well as training curriculums for professionals who educate and care for children and youth.
• Embed education about healthy screen use into prenatal and parenting support programs.

What educators can do

• Model balanced and healthy use of technology.
• Implement curriculum aimed at digital literacy, responsible digital engagement, and critical thinking.
• Uphold technology-related school policies.
• Use screen-free teaching methods.
• Foster inclusive, offline opportunities for connection and engagement.
• Invite feedback from students on classroom norms and practices for technology use.

What communities can do

• Increase inclusive and accessible options for people to connect and engage offline across a range of interests and activities, such as recreational activities, regulated childcare and after school programs, youth job and volunteer opportunities.
• Advocate for collective change in digital culture.

What individuals and families can do

• Follow the Canadian Pediatric Society's recommendations for screen time:
  • Under 2 years: screen time is not recommended apart from video chatting with caring adults.
  • Preschool: minimize, mitigate, be mindful, model.
  • School age: manage, make it meaningful, model, monitor.
• Follow the Canadian 24-hour Movement Guidelines recommendations, including limiting recreational screentime to no more than 2 hours a day for school-aged children.
• Choose the applications/device that meet the minimum communication needs of the developmental stage and further delay access to social media.
• Support the development of critical thinking skills (digital literacy) before and while children engage with the online environment.
• Advocate for collective change in digital culture and participate in community efforts to expand screen-free recreational and social opportunities.

Learn more:

• Digital Health Task Force (Canadian Paediatric Society)
• 24-Hour Movement Guidelines: Early years to older adults

Footnotes

References

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Office of the United Nations High Commissioner for Human Rights. (n.d.). Children's rights in the digital environment. https://www.ohchr.org/en/children/childrens-rights-digital-environment

UNICEF Australia. (2025, December 9). Social media ban: A simple guide.
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Bodoky, F. (2026, February 23). Social media ban for youth: What European countries are planning. Digitec. https://www.digitec.ch/en/page/social-media-ban-for-youth-what-european-countries-are-planning-41642

U.S. Department of Health and Human Services. (2026). Surgeon General's warning on the harms of screen use: An advisory and toolkit on how to protect children and adolescents. https://www.hhs.gov/sites/default/files/us-surgeon-generals-advisory-warning-on-the-harms-of-screen-use.pdf [hhs.gov]

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Institut national de santé publique du Québec. (2023, April). Usage des écrans par les parents en présence de leur enfant de 0 à 6 ans : les effets sur les pratiques parentales (Synthèse des connaissances) [PDF]. https://www.inspq.qc.ca/sites/default/files/publications/3307-usage-ecrans-parents-presence-enfant-0-6-ans.pdf

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Toigo, S., Wang, C., Prince, S. A., Varin, M., Roberts, K. C., and Betancourt, M. T. (2025). Recreational screen time and mental health among Canadian children and youth. Health Promotion and Chronic Disease Prevention in Canada, 45(7–8), 311–322. https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-45-no-7-8-2025/recreational-screen-time-mental-health-canadian-children-youth.html

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Shannon, H., Bush, K., Villeneuve, P. J., Hellemans, K. G. C., and Guimond, S. (2022). Problematic social media use in adolescents and young adults: Systematic review and meta-analysis. JMIR Mental Health, 9(4), e33450. https://mental.jmir.org/2022/4/e33450

Istituto Superiore di Sanità. (2022). Problematic social media use and health symptoms among adolescents [PDF]. https://www.epicentro.iss.it/hbsc/pdf/Problematic%20social%20media%20use.pdf

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Charlebois, S., and Kelly, S. (2025). Protecting Canada's youth from the risks of exposure to gambling advertising. Canadian Medical Association Journal, 197(29), E918–E919. https://doi.org/10.1503/cmaj.251227

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Fuller, A., Vasek, M., Mariconti, E., and Johnson, S. D. (2024). Understanding and preventing the advertisement and sale of illicit drugs to young people through social media: A multidisciplinary scoping review. Drug and alcohol review, 43(1), 56–74. https://doi.org/10.1111/dar.13716

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Date modified:

2026-06-30