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So here you are, gazing into a screen when you could be meeting with a colleague, salsa dancing, or sharing lunch with a friend. What effect is all of this online time having on your health? And what—if anything—should you tell your patients about their own Internet use?
 
As more of our interactions are shifting to online—not only use of social media and computer games, but also shopping, medical appointments, banking, and nearly every other sphere of human activity—many people need help understanding the effects on their health. “Clinicians are in a position to educate,” says Brian A. Primack, MD, PhD, director of the Center for Research on Media, Technology, and Health at the University of Pittsburgh, Pennsylvania.
 
Adults spent 5.9 hours per day on digital media in 2017, up from 5.6 hours in 2016.[1] The American Academy of Pediatrics has formulated guidelines for children,[2] but only recently have researchers started to articulate recommendations for adults. Evidence is emerging that the trend to interact through digital media poses both opportunities and threats, they say. Those who wield their digital tools to enhance their face-to-face social lives are thriving. But when the Internet becomes a substitute for face-to-face interaction, it might starve patients of emotional nourishment.
 
The observation that people like spending time together dates back at least to Aristotle,[3] and anthropological findings suggest that we were social far back into prehistory. More recently researchers have documented the ways that social networks protect against disease. People who see more friends more often in real life don’t just feel more cheerful; they actually live longer and experience less disability.[4,5]
 
 
The benefits derive partly from practical support, such as transportation to a medical appointment. Friends and family also encourage each other in healthy behaviors. More subtly, these relationships appear to reduce the risk for disease as measured by immune, vascular and metabolic functions—even gene expression.[4,5,6]
 
But more Americans are now living[7] and working alone[8] than in decades past, and these trends have already raised concerns about mounting social isolation. In this context, does the opportunity to connect online help or hurt? The answer from the studies so far is…both.
 
One branch of research suggests that the Internet—particularly social media—can attenuate social isolation, particularly for people who face physical barriers to meeting up with other people, such as disability or living in a remote location, or for people with stigmatizing conditions.[9] “Particularly for older adults, the Internet can really help them stay in contact with their social ties, and help them feel like they’re an important part of their social network; that has positive impact on their lives,” says Shelia R. Cotten, PhD, a professor in the Department of Media and Information at Michigan State University.
 
“Research suggests that social media can attenuate social isolation, particularly for people who face physical barriers to meeting up with other people.”
  1. Molla R. Mary Meeker’s 2018 internet trends report: All the slides, plus analysis. Recode. May 30, 2018. Source Accessed September 24, 2018.
  2. American Academy of Pediatrics announces new recommendations for children’s media use. American Academy of Pediatrics. May 21, 2016. Source Accessed September 24, 2018.
  3. Aristotle. Politics. Book 1, section 1253a. Perseus Digital Library, Tufts University. SourceAccessed September 24, 2018.
  4. Hobbs WR, Burke M, Christakis NA, Fowler JH. Online social integration is associated with reduced mortality risk. Proc Natl Acad Sci U S A. 2016;113:12980-12984. doi:10.1073/pnas.1605554113
  5. Cotten SR, Anderson WA, McCullough BM. Impact of Internet use on loneliness and contact with others among older adults: cross-sectional analysis. J Med Internet Res. 2013;15:e39. doi:10.2196/jmir.2306
  6. Primack BA, Shensa A, Sidani JE, et al. Social media use and perceived social isolation among young adults in the U.S. Am J Prev Med. 2017;53:1-8. doi:10.1016/j.amepre.2017.01.010
  7. Kreider RM, Vespa J. The historic rise of living alone and fall of boarders in the United States: 1850-2010. SEHSD Working Paper no. 2015-11. 2015. Census.gov. Source Accessed September 24, 2018.
  8. The 2017 state of telecommuting in the U.S. employee workforce. Flexjobs.com. SourceAccessed September 24, 2018.
  9. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10:227-237. doi:10.1177/1745691614568352
  10. Ellison N, Steinfield C, Lampe C. The benefits of Facebook “friends:” social capital and college students’ use of online social network sites. J Comput Mediat Commun. 2007;12:1143-1168. doi:10.1111/j.1083-6101.2007.00367.x
  11. Shensa A, Sidani JE, Escobar-Viera CG, et al. Real-life closeness of social media contacts and depressive symptoms among university students. J Am Coll Health. 2018:1-8. doi:10.1080/07448481.2018.1440575
  12. Bennett C, Underdown A, Barlow J. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane Database Syst Rev. 2013 Apr 30;(4):CD005038. doi: 10.1002/14651858.CD005038.pub3.