Easier Access To Media By Children Increases Risk For Influence On Numerous Health Issues

Victor C. Strasburger, M.D., of the University of New Mexico School of Medicine, Albuquerque, presented the commentary at a JAMA media briefing in New York.

On average, children and adolescents spend more than 6 hours a day with media—more time than in formal classroom instruction, writes Dr. Strasburger. In addition, U.S. youth have unprecedented access to media (two-thirds have a television set in their bedrooms, half have a VCR or DVD player, half have a video game console, and almost one-third have Internet access or a computer), making parental monitoring of media use difficult.

All of this media access does have an influence on a variety of health issues, according to Dr. Strasburger. "The media are not the leading cause of any pediatric health problem in the United States, but they do make a substantial contribution to many health problems, including the following."

• Violence - Research on media violence and its relationship to real-life aggression is substantial and convincing. Young persons learn their attitudes about violence at a very young age and, once learned, those attitudes are difficult to modify. Conservative estimates are that media violence may be associated with 10 percent of real-life violence.
• Sex - Several longitudinal studies have linked exposure to sex in the media to earlier onset of sexual intercourse. The media represent an important access point for birth control information for youth; however, the major networks continue to balk at airing contraception advertisements at the same time they are airing unprecedented amounts of sexual situations and innuendoes in their primetime programs.
• Drugs - Witnessing smoking scenes in movies may be the leading factor associated with smoking initiation among youth. In addition, young persons can be heavily influenced by alcohol and cigarette advertising. More than $20 billion a year is spent in the United States on advertising cigarettes ($13 billion), alcohol ($5 billion), and prescription drugs ($4 billion).
• Obesity - Media use is implicated in the current epidemic of obesity worldwide, but it is unclear how. Children and adolescents view an estimated 7,500 food advertisements per year, most of which are for junk food or fast food. Contributing factors to obesity may include that watching television changes eating habits and media use displaces more active physical pursuits.
• Eating Disorders - The media are a major contributor to the formation of an adolescent's body self-image. In Fiji, a naturalistic study of teenage girls found that the prevalence of eating disorders increased dramatically after the introduction of American TV programs.

Dr. Strasburger adds that network contraceptive advertising should be encouraged and legislation should be passed banning all cigarette advertising in all media and limiting alcohol advertising to advertisements that only show the product.

Education of parents, teachers, and clinicians about these issues is necessary, and education of students about the media should be mandatory in schools. "Parents have to change the way their children access the media—not permitting TV sets or Internet connections in the child's bedroom, limiting entertainment screen time to less than 2 hours per day, and co-viewing with their children and adolescents. Research has shown that media effects are magnified significantly when there is a TV set in the child's or adolescent's bedroom."

At the same time, media can be an extraordinary positive power, writes Dr. Strasburger. "Antiviolence attitudes, empathy, cooperation, tolerance toward individuals of other races and ethnicities, respect for older people—the media can be powerfully prosocial." Media can also be used constructively in the classroom in ways that are better than traditional textbooks, such as for viewing plays on DVDs or documentaries of historical events.

"The media are a powerful teacher of children and adolescents—the only question is what are they learning and how can it be modified? When children and adolescents spend more time with media than they do in school or in any leisure-time activity except for sleeping, much closer attention should be paid to the influence media has on them," Dr. Strasburger concludes.