It was the hush that worried the US’s top doctor as he toured the country’s university campuses last year.

Dr Vivek Murthy went to places including Duke, University of Texas and Arizona State, but so many youngsters were plugged into earphones and gazing into laptops and phones that it was incredibly quiet in the communal areas. Where was the loud chatter Murthy remembered from his college days?

“Students said to me, ‘how are we supposed to start a conversation?’” the US surgeon general told the Guardian. “It’s just not the culture any more to talk to one another. It’s an indictment of the trends that we’ve seen.”

Figures published on Wednesday reveal one possible impact of that screen obsession: for the first time since the data was first collected in 2012, 15- to 24-year-olds in North America say they are less happy than older generations. The gap is closing in western European nations and in March Murthy flew to London to further his campaign against falling levels of happiness, particularly among the young. He is also worried about youth wellbeing in Japan, South Korea and India.

The replacement of person-to-person social connection, whether through clubs, sports teams, volunteering or faith groups, is a particular concern to the Yorkshire-born medic. Education, housing and transport initiatives that do not focus on improving wellbeing are also a worry.

But perhaps the biggest problem in his opinion is the explosion of social media use, which has caused “extraordinary harms”.

It is notable that Murthy is focusing so hard on this social issue. At a conference at the LSE in London on Monday, academics and researchers in the fast-developing field of wellbeing science gave him a standing ovation.

There are clear physical impacts of misery for world leaders to consider. Social disconnection in the US has led to “a 29% increase in the risk of heart disease, a 32% increase in the risk of stroke and a 50% increase in the risk of dementia among older individuals,” he said.

Last year, Murthy, who was first appointed to his role by Barack Obama and again by Joe Biden, issued a formal US-wide warning that social media presented “a profound risk of harm” to the mental health and wellbeing of children and adolescents. “We do not yet have enough evidence to determine if social media is sufficiently safe” for them to use, it said.

“I’m still waiting for companies to show us data that tells us that their platforms are actually safe,” he added.

He compared tech companies to 20th-century car giants producing vehicles without seatbelts and airbags until legislation mandated it.

“What’s happening in social media is the equivalent of having children in cars that have no safety features and driving on roads with no speed limits,” he said. “No traffic lights and no rules whatsoever. And we’re telling them: ‘you know what, do your best – figure out how to manage it.’ It is insane if you think about it.”

The result is that parents feel “this whole thing [managing the impact of social media] has been dumped on their shoulders”.

Murthy said that between 2000 and 2020 there has been a 70% decrease in the amount of in-person time young people in the US spent with their friends. Meanwhile, “our recent data is telling us that adolescents are spending on average 4.8 hours a day on social media … a third of adolescents are staying up till midnight or later on weeknights on their devices”.

Last Sunday, he met with a group of young people in a park in west London and concluded their phones were feeding them a diet of “headlines that are constantly telling them that the world is broken, and that the future is bleak”.

“And they said: you receive that again and again and again. You start to internalise that. You sort of lose a sense of hope.”

He is interested, too, in how burgeoning social media use fuels “hustle culture” that teaches young people that they ought to build a “personal brand” and even an income stream alongside studying and growing up.

“I ask [young people] what hustle culture is telling you success is,” he said. “They say some version of fame, followers and fortune. I have had too many young people say what they feel like they’ve really got to do right now is build their brand. And they don’t say that ironically.”

He said social media companies should limit or eliminate “features that try to get kids to drive towards other people liking, reposting and commenting on their posts”, such as buttons and infinite scroll mechanisms that can be addictive, damage self-esteem and erode time available for other activities.

“The platforms have the power to do that,” he said.

Governments have been slow to install mandatory guardrails on social media platforms and should have done so 10 years ago, he said. “What has happened is a fundamental failure of governments to protect young people from the harmful effects of a new technology and it’s not new any more.”

To counteract the trend, Murthy wants governments to start measuring their policies in terms of their impact on real world social connection.

“Think about policies that carve up our cities and towns with highways and roadways and separate us from one another,” he said. “Think about the power of policy to actually put public transportation in place and bring people back together. Housing design can have a powerful impact on how people come together.”

In 2021, the leader of the UK opposition, Keir Starmer, said a Labour government would weigh spending plans based on their effect on wellbeing in addition to national income.

But for now he compares the status quo with social media to a doctor being allowed to run a hospital where floors are so slippery that people fall and break their hips, patients suffer blood clots because medicine is not being administered and become infected because dirty equipment is being used. His point is it would not happen. Protections are needed immediately, he said.

“If you’ve got a 12-year-old and a 15-year-old, you don’t have three to five years to wait,” he said. “Our kids’ childhoods are happening right now. I worry that there isn’t enough of a sense of urgency in government.”

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