Screens are not the problem
I hope you’re smoothly going back into academic or work routine after your vacation, whether it was a short or long one. Holidays often provide a good opportunity to regain healthy lifestyle habits, such as getting 7–8 hours of sleep per night, eating better without rushing, and ensuring daily physical activity, at least at a minimum level.
This August, I couldn’t help noticing the minimal daily physical activity of the youngest children who I saw on the streets. I remember my summers playing on the beach or in the street with other kids, surrounded by balls, bicycles, marbles, card games, etc. It’s true that lately, we all see more children with screens in their hands, even sitting in groups, staring at their devices without looking at each other, spending hours and hours on them — something unthinkable about 20–30 years ago.
At home, I recall some initiatives from my children’s schools related to this issue, like Empatallados (Screened In), making it clear that the teaching community saw this coming a long time ago.
When bringing this topic into the realm of health policy, I found a considerable amount of literature. The so-called Internet Gaming Disorder (IGD), known as “video game addiction,” is a pathology increasingly trending and rising in both psychology and public health, which is why it has begun to be studied in recent decades. However, estimates vary considerably due to differences in definitions and diagnostic methods used in studies. This is what makes it difficult to group together the use of video games or mobile phones (and social media apps).
Furthermore, the global prevalence of this condition varies widely in the scientific literature, with studies reporting figures ranging from 1% to 10% of video game players, depending on the region, the population studied, and the diagnostic criteria used. A meta-analysis published in 2021 found an average global prevalence of 3.05% among video game players. In Europe, the prevalence is generally estimated to be between 2% and 5% of players, although some studies report higher figures in specific groups, such as teenagers. Another study conducted in Germany found a prevalence of this disorder of 1.2% in the general population, but with higher rates among the male, reaching up to 3.5%. In the United Kingdom, it is estimated that around 1.3% of players might meet the selection criteria for this disorder.
In Spain, a report from the Ministry of Health on behavioral addictions indicated that 3.6% of teenagers aged 14 to 18 might be at risk of developing the pathology. Various publications suggest that around 3.2% of them met the criteria for IGD, with a higher prevalence in males than in females. Data on adults are less frequent, but 2017 data indicated a prevalence of 1.6% in a sample of young adults.
As I mentioned in the fourth paragraph, the variability in the figures is due to the lack of a single, universally accepted definition. Different studies use different diagnostic criteria, such as those established in the DSM-5 or the ICD-11, which can lead to different prevalence estimates.
For this reason, the literature on health economics is also limited, with constraints in the availability of specific economic data.
However, I have a clear idea of what its future key research areas will be: in direct costs, we could consider medical expenses related to the treatment of the pathology (and obesity, which is often added to the clinical case): psychological or digital therapies, psychiatric consultations, and medications. Also, we must not forget the costs associated with hospitalization or rehabilitation programs.
For indirect costs, we could take into account the loss of productivity at work or school and absenteeism due to the addiction, the impact on quality of life and social relationships, which could lead to long-term costs.
We could estimate some intangible costs, such as the effects on mental health, like anxiety, depression, and stress, which are not easily quantified in monetary terms. Also, the costs in the quality of life of patients and their families. Let’s not forget the added consequences of not being in a healthy physical condition.
The social costs are evident, with an impact on social security and community services, as well as the need for public policies and prevention campaigns, which imply a cost to the health system.
With specific data and an appropriate definition of the pathology, its prevalence and incidence data would lead us to conduct studies from the perspective of health economics, such as cost-benefit, cost-effectiveness and burden of disease analysis, among others.
Research on this pathology is still developing, but it has evident potential to create more effective policies and treatments in the future.
By no means am I criticizing the use of technology, I firmly believe in a global and digital world, fully connected and with countless opportunities in the digital economy, but it is evident that, like everything in life, improper use, or something as simple as not knowing how to organize your time or the time of your loved ones properly, is already leading to the emergence of new pathologies of the 21st century.
The problem is not the screens.
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On the Draft Royal Decree regulating Health Technology Assesment in Spain. Minister of Health. Government of Spain. Jose A Vidal´s translation.
Monitoring our health: sometimes keep it simple has it advantages. Enrique Dans.
Cyber security in the health and medicine sector: a study on available evidence of patient health consequences resulting from cyber incidents in healthcare settings. Danny Van Roijen.
Introducing artificial intelligence to hospital pharmacy departments. Jose Manuel Martínez Sesmero, Yared González y Alfredo Montero.
Scientists need more time to think. Nature.
Germany inches closer to confidential pricing for drugs. Pharmaphorum.
ICH reflection paper marks milestone in harmonization of real-world evidence use in medicines regulation. The evidence base online.
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