The Digital Choices Shaping our Children’s Health

Around the world, childhood is being reprogrammed by digital technologies that shape how young people learn, play, and connect. But children and young people are not experimental subjects, a captive market, or a commodity, which is why we must shape digital environments that protect and support their healthy development. Listen to this commentaryPlease log in to listen to this commentary 0:00 / 0:00Audio unavailable PARIS/GENEVA— From social media and online gaming to generative AI systems, digital environments are powerful determinants of people’s health. That is especially true of children and young people. Around the world, childhood is being reprogrammed by digital technologies that shape how young people learn, play, and connect. Our task is not to celebrate or condemn technology. It is to face a simple truth: our digital environment not only promises far-reaching benefits but also poses grave risks for children’s health and development. Our responsibility is to maximize the first while preventing the second. It is not too late to act, but it is too late for merely incremental adjustments. Digital tools can expand opportunity by supporting learning, communication, and access to health services, especially for children in remote or crisis-affected settings. For many young people, online spaces also offer creativity, community, and belonging, particularly for those facing exclusion offline. But these benefits are not guaranteed; they depend heavily on who has access, how technologies are designed, and whose interests they serve. Governments are increasingly recognizing that protecting children online is a public-health imperative. Australia has implemented the world’s first requirement that social-media platforms prevent children under 16 from holding accounts, while France is advancing legislation to prohibit access to social media for those under 15. Indonesia has banned access for children under 16, Spain has announced plans to do so, and Ireland is working with European Union partners to develop age restrictions and age-assurance systems focused on protecting under-16s. The United Kingdom, too, recently announced plans to ban social-media platforms from offering services to under-16s, alongside additional safeguards like restrictions on livestreaming and contacts from strangers. And Canada has introduced legislation to restrict access to social media for children under 16 while requiring stronger safety-by-design protections and accountability from platforms. PS Quarterly: The Declaration Heard Round the World, is here. In this issue of PS Quarterly—available exclusively to Premium subscribers—Danielle Allen, Sarah M.S. Pearsall, Steve Pincus, and other leading thinkers examine the impact, limitations, and legacy of America’s founding document, and consider where US democracy is headed 250 years later. Subscribe to PS Premium Together, these measures reflect a growing global consensus that digital environments require effective governance, age-appropriate design, and stronger safeguards to protect child health. The World Health Organization is supporting this by strengthening the research needed to develop a clearer understanding of the impact of today’s and tomorrow’s technologies, providing technical advice to countries, and promoting safe, equitable digital health environments. Solutions are needed because digital environments are not neutral. How they are designed, governed, and monetized shapes many aspects of our lives, not least our health. For example, repeated exposure to stereotyped, sexualized, violent, or discriminatory content shapes how children understand themselves and the world around them. Algorithms increasingly filter health information to increase attention rather than accuracy, allowing misleading claims to spread. The collection and use of personal data, particularly for profiling and targeted marketing, raise concerns about privacy, manipulation, and well-being. Current evidence associates excessive digital exposure with problems such as anxiety, depression, poor sleep, increased aggression, and, in more severe cases, suicidality, especially among vulnerable adolescents. Digital marketing on platforms may expose people to promotion of harmful products, such as tobacco, alcohol, and gambling platforms. Social media, gaming, and AI use can deepen loneliness and displace offline relationships. Prolonged use contributes to sedentary behavior and reduced sleep, which are known risk factors for noncommunicable diseases. Online sexual exploitation and abuse are also increasing globally, alongside a sharp rise in child sexual abuse material, AI-generated abuse imagery, and deepfake sexual or bullying content. These have profound and lasting consequences for mental health, trust, and safety. Commercial practices increase all these risks. Many platforms are designed to maximize engagement, without adequate protection from exposure to harmful content or features to protect children’s physical and mental health. Reducing exposure to illegal or extreme and graphic content is essential. But children’s well-being requires more than the absence of harm. It depends on stable relationships, appropriate boundaries, physical activity, and opportunities for real-world social connection. Risks multiply when digital environments disrupt—rather than support—healthy development. Generative AI is a major force multiplier in terms of both risks and opportunities for child well-being. Used responsibly, purpose-built AI tools may support education, accessibility, and health. But their long-term impact on children’s expectations of relationships, empathy, or self-regulation are unclear. As long as that remains true, a precautionary approach is not anti-innovation. It is pro-child. Digital balance is part of the solution. While digital environments require regulation, transparency, age-appropriate design, stronger safety and trust features, and accountability, evidence must keep pace with technology, requiring independent, longitudinal research across income settings and regions. Above all, we must listen to today’s youth. As active users of technology, they can help digital environments evolve responsibly. The online and offline worlds now form a single space where digital tools can support healthy development—or crowd it out. Young people should bring their own lived experiences to bear in order to help shape appropriate guardrails. Parents, caregivers, schools, and communities must also be part of this conversation. This process demands sustained collaboration across governments, industry, civil society, and public-health institutions, built on a shared commitment to maximizing benefits and minimizing harms. More transparency, data sharing, health-promoting design choices, and corporate support for effective safety standards, especially for minors, are essential. The WHO can play its convening role and influence in setting norms and standards. Our children and young people are not experimental subjects, a captive market, or a commodity. Together, we can and must shape digital environments that protect and support their healthy development. The choices we make now will echo for generations. PARIS/GENEVA— From social media and online gaming to generative AI systems, digital environments are powerful determinants of people’s health. That is especially true of children and young people. Around the world, childhood is being reprogrammed by digital technologies that shape how young people learn, play, and connect. Our task is not to celebrate or condemn technology. It is to face a simple truth: our digital environment not only promises far-reaching benefits but also poses grave risks for children’s health and development. Our responsibility is to maximize the first while preventing the second. It is not too late to act, but it is too late for merely incremental adjustments. Digital tools can expand opportunity by supporting learning, communication, and access to health services, especially for children in remote or crisis-affected settings. For many young people, online spaces also offer creativity, community, and belonging, particularly for those facing exclusion offline. But these benefits are not guaranteed; they depend heavily on who has access, how technologies are designed, and whose interests they serve. Governments are increasingly recognizing that protecting children online is a public-health imperative. Australia has implemented the world’s first requirement that social-media platforms prevent children under 16 from holding accounts, while France is advancing legislation to prohibit access to social media for those under 15. Indonesia has banned access for children under 16, Spain has announced plans to do so, and Ireland is working with European Union partners to develop age restrictions and age-assurance systems focused on protecting under-16s. The United Kingdom, too, recently announced plans to ban social-media platforms from offering services to under-16s, alongside additional safeguards like restrictions on livestreaming and contacts from strangers. And Canada has introduced legislation to restrict access to social media for children under 16 while requiring stronger safety-by-design protections and accountability from platforms. PS Quarterly: The Declaration Heard Round the World, is here. In this issue of PS Quarterly—available exclusively to Premium subscribers—Danielle Allen, Sarah M.S. Pearsall, Steve Pincus, and other leading thinkers examine the impact, limitations, and legacy of America’s founding document, and consider where US democracy is headed 250 years later. Subscribe to PS Premium Together, these measures reflect a growing global consensus that digital environments require effective governance, age-appropriate design, and stronger safeguards to protect child health. The World Health Organization is supporting this by strengthening the research needed to develop a clearer understanding of the impact of today’s and tomorrow’s technologies, providing technical advice to countries, and promoting safe, equitable digital health environments. Solutions are needed because digital environments are not neutral. How they are designed, governed, and monetized shapes many aspects of our lives, not least our health. For example, repeated exposure to stereotyped, sexualized, violent, or discriminatory content shapes how children understand themselves and the world around them. Algorithms increasingly filter health information to increase attention rather than accuracy, allowing misleading claims to spread. The collection and use of personal data, particularly for profiling and targeted marketing, raise concerns about privacy, manipulation, and well-being. Current evidence associates excessive digital exposure with problems such as anxiety, depression, poor sleep, increased aggression, and, in more severe cases, suicidality, especially among vulnerable adolescents. Digital marketing on platforms may expose people to promotion of harmful products, such as tobacco, alcohol, and gambling platforms. Social media, gaming, and AI use can deepen loneliness and displace offline relationships. Prolonged use contributes to sedentary behavior and reduced sleep, which are known risk factors for noncommunicable diseases. Online sexual exploitation and abuse are also increasing globally, alongside a sharp rise in child sexual abuse material, AI-generated abuse imagery, and deepfake sexual or bullying content. These have profound and lasting consequences for mental health, trust, and safety. Commercial practices increase all these risks. Many platforms are designed to maximize engagement, without adequate protection from exposure to harmful content or features to protect children’s physical and mental health. Reducing exposure to illegal or extreme and graphic content is essential. But children’s well-being requires more than the absence of harm. It depends on stable relationships, appropriate boundaries, physical activity, and opportunities for real-world social connection. Risks multiply when digital environments disrupt—rather than support—healthy development. Generative AI is a major force multiplier in terms of both risks and opportunities for child well-being. Used responsibly, purpose-built AI tools may support education, accessibility, and health. But their long-term impact on children’s expectations of relationships, empathy, or self-regulation are unclear. As long as that remains true, a precautionary approach is not anti-innovation. It is pro-child. Digital balance is part of the solution. While digital environments require regulation, transparency, age-appropriate design, stronger safety and trust features, and accountability, evidence must keep pace with technology, requiring independent, longitudinal research across income settings and regions. Above all, we must listen to today’s youth. As active users of technology, they can help digital environments evolve responsibly. The online and offline worlds now form a single space where digital tools can support healthy development—or crowd it out. Young people should bring their own lived experiences to bear in order to help shape appropriate guardrails. Parents, caregivers, schools, and communities must also be part of this conversation. This process demands sustained collaboration across governments, industry, civil society, and public-health institutions, built on a shared commitment to maximizing benefits and minimizing harms. More transparency, data sharing, health-promoting design choices, and corporate support for effective safety standards, especially for minors, are essential. The WHO can play its convening role and influence in setting norms and standards. Our children and young people are not experimental subjects, a captive market, or a commodity. Together, we can and must shape digital environments that protect and support their healthy development. The choices we make now will echo for generations.