A new study in the Journal of the American Medical Association, or JAMA, finds that the health of America’s youth has significantly worsened across every major health indicator since 2007.
What are the factors driving this decline? And why do kids in the U.S. seem to be doing so poorly?
Dr. Deborah Cohen is an associate professor in the Department of Psychiatry at Dell Medical School and the UT Austin School of Social Work and co-director of the Center for Youth Mental Health. She spoke with Texas Standard about the causes of the declining mental health of young people. Listen to the interview above or read the transcript below.
This transcript has been edited lightly for clarity:
Texas Standard: This is a study that draws on data from several national surveys, mortality statistics, and electronic health records from over 2 million children over 17 years. It’s a rather comprehensive overview.
As you focus on mental health, is this decline something you’ve seen in your own patients?
Deborah Cohen: Yes, so what we’ve been seeing in the individuals that we serve in Greater Austin and also in all the national surveys is a steady increase in anxiety and depression rising since the early [2010s].
This study found that U.S. children and teens were nearly twice as likely to die as their peers in 18 other high-income countries. You don’t specialize in the mortality aspect of this study, but broadly speaking, why does it appear that America’s children are so unhealthy and what causes do you read from this study?
As we said, we have been noticing a rise in anxiety and depression. We are seeing that alongside a reduction in unstructured outdoor play among young people. Millennials and Gen X kids were more likely to play outside in their childhood, and we aren’t seeing that as often in individuals born since 2000.
The other thing is the rise of technology – having what Jonathan Haidt refers to as a “phone-based” or device-based childhood that’s replacing that unstructured outdoor play.
There has been a lot of talk about the potential role of social media in this youth mental health crisis, but often it’s sort of lumped in together with “too much screen time.” Are there factors that perhaps don’t get the kind of close-up tension that these broader ideas of “too much tech” are getting?
It’s much more complex than just saying people are on Instagram too long.
The biggest thing that we are noticing around young people is the skills that they need to learn by having unstructured conversations with their peers to work through any sort of conflicts they have… When you’re online and you’re participating in a conversation in a comment section, that is asynchronous. They’re not gaining the same critical thinking skills, problem-solving skills, and conflict management skills that they need to be successful when they are on a college campus or in the workplace.
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Periodically we have heard about studies like this, though few as comprehensive as this one — digging into the data over this 17-year period. But for all the talk, it does not seem like there has been much change.
If Texas policymakers, for example, wanted to genuinely make a difference – wanted to get the needle moving in the other direction – what would they need to do? Or is this beyond the reach of public policy? How do you see that?
I’d say it’s both. Actually, the session that just ended, they did focus on this. We joined some other states in making our public schools phone-free. So we will no longer be having phones in our cafeteria in our middle schools. That’s one of the big areas people have been talking about, is we want our middle schoolers to have those awkward conversations in person instead of on a phone.
So we have taken some public policy steps to make this change, but this isn’t entirely a public policy space. A lot of this needs to happen at the parent and neighborhood level. Having parents have conversations about when they’re introducing, whether they’re using just a flip phone versus a smartphone, how they’re encouraging their children to have unstructured time with their neighbors.
If you just look around your neighborhood, you’ll notice there’s not as many kids just out riding a bike like there were when I grew up. That sort of developmental play is really, really important, and we’re starting to lose that.
Correction: A previous version of this story incorrectly stated how long youth anxiety and depression has seen a steady increase; it is since the early 2010s.
