According to the Daily Mail, using Facebook “could raise your risk of cancer”. The newspaper reported that social networking sites “could raise your risk of serious health problems by reducing levels of face-to-face contact”.

This, and several other media reports, is based on an article expressing the opinion of the psychologist Dr Aric Sigman, who is concerned that a reduction in personal contact could increase the risks of heart disease, stroke and dementia. In this article, he refers to a selection of studies that have informed this opinion. However, the article is not a systematic review, meaning that it may not take into account all relevant studies, some of which might not support the author’s views.

Most of the studies discussed looked at the effects of social isolation on health, with no reporting of whether isolation was caused by increased computer usage. Also, none of the research cited studied whether computer usage directly caused adverse health effects, or whether social isolation or computer use affected the risk of developing cancer.

It is possible that using social networking sites might, in fact, reduce social isolation and loneliness, but this possibility is not addressed by the article. While interesting, people who use social networking sites should not be concerned by the article's claims.

Where did the story come from?

These news reports are based on an article written by Dr Aric Sigman, who is a Member of the Institute of Biology (IOB), a Fellow of the Royal Society of Medicine and an Associate Fellow of the British Psychological Society. No sources of funding for writing the article were reported. The study was published in the peer-reviewed journal Biologist, which is the journal of the IOB.

What kind of scientific study was this?

This was a non-systematic review discussing the possible effects on health of social networking on the internet.

The author discusses various studies looking at changes in computer use and in social interaction, as well as studies looking at the health effects of social isolation.

What were the results of the study?

The author reports that people in Britain now spend about 50 minutes a day “interacting socially with other people”, and a 2003 study from the Office of National Statistics (ONS) is cited to support these figures. He also states that couples spend less time with each other and parents spend less time with their children than a decade ago. He says that the number of people working and living on their own is increasing (also attributed to the ONS).

The article also reports that there has been “rapid proliferation of electronic media”, suggesting this “is now the most significant contributing factor to society’s growing physical estrangement”.

The article features a graph showing that time spent in daily face-to-face social interaction has declined from about six hours in 1987 to about two to three hours in 2007. This decline is plotted next to results that report that time spent in electronic media use has increased from about four hours in 1987 to almost eight hours in 2007. These figures are reported to come from “time use and demographic studies”.

The author asserts that the use of earphones, mobile phones, laptops or Blackberries are reasons for “physical and social disengagement”. He also notes that there have been deaths caused by people accidentally stepping into traffic while they were wearing an MP3 player, leading to proposals in the US Senate to ban the use of these and other devices whilst crossing the road.

The article also reports various studies that have found that children spend more time in front of the television and computer than doing anything else, that they spend five to 10 times longer watching television than with their parents, and that about a quarter of five-year-old children in Britain own a computer or laptop. An ongoing study was reported to find that social networking has “overtaken fun (online games) as the main reason for using the internet” among young children.

The author also says that UK social networking usage is the highest in Europe, and that time spent interacting socially is now being supplanted by “virtual” interaction. The article goes on to discuss what the health effects of a reduction in physical interaction might be. These effects are reported in six categories, relating to genetics, immunology, sleep, morbidity, mortality and marriage/cohabitation.

Genetic effects

Research at the UCLA School of Medicine is reported to have found that social isolation can affect the level to which genes are active in white blood cells. People reporting high levels of social isolation had 78 genes that were more active and 131 genes that were less active than in people with low levels of social isolation.

The genes that were less active are reported to include those involved in the body’s response to stress and illness, while those that were more active are reported to include those involved in promoting inflammation during stress and illness. The authors of this research are reported to believe that their findings may explain the “greater risk of inflammatory disease and adverse health outcomes in individuals who experience high levels of subjective social isolation”.

Immunological effects

One study is reported to have found that women with breast cancer who reported more social activity and social satisfaction had “stronger stimulated TNF-alpha responses”. TNF-alpha is a compound produced by immune-system cells, and is “associated with tumour regression and increased survival time for cancer patients”. Another study is reported to find increased levels of a particular type of immune-system cell among those women with ovarian cancer who reported a greater amount of social support.

The article’s author also reports that loneliness has been linked to “low-grade peripheral inflammation” and may therefore be linked to inflammatory diseases, and that lack of social connection or loneliness has also been linked to increased risk of cardiovascular disease.

Sleep effects

One study is reported to have found that lonely people sleep less efficiently and spend more time awake. The author reports that poor sleep has been linked to a number of adverse effects.

Morbidity

The author reports that “several decades of research has found that greater social contact is related to reduced morbidity, while fewer contacts lead to increased morbidity”. The article discusses studies that looked at stroke risk, blood pressure, susceptibility to colds, cognitive function and dementia.

Mortality

Studies are reported that found increased risk of mortality in apparently healthy persons who retired early, and a reduction in mortality in those who regularly attended church or took part in other social activities.

Marriage and cohabitation

Studies are discussed that have found that rate of suicide is lowest among people who are married, and that being single increases risk of mortality. However, the author does mention that American criminologists have linked the falling murder rate to the fall in marriage rates “as husbands now have fewer opportunities to kill wives”.

What interpretations did the researchers draw from these results?

The author concludes that “while the precise mechanisms underlying the association between social connection, morbidity and mortality continue to be investigated, it is clear that this is a growing public health issue for all industrialised countries”.

The author goes on to discuss a study that found internet usage was linked to reduced social interaction and communication within families, and increased levels of loneliness and depression. He suggests children are now having less social interaction and adults are more likely to live alone.

Finally, he suggests that biologists can provide “concrete and measureable” evidence about the importance of social connection, and this may be the key to increasing public awareness of the problem.

What does the NHS Knowledge Service make of this study?

This study was not a systematic review. It is an article that expresses the opinion of the author, who cites various studies that have informed this opinion. As this was not a systematic review there may be other relevant studies that the author has not included. Some of these studies may not support the author’s opinions.

None of the studies that the author discussed looked at whether social networking or computer usage directly caused adverse health effects. Most of the studies looked instead at the effects of social isolation or loneliness, with no report of whether these were caused by increased computer usage.

None of the studies described found that loneliness, social isolation or social networking affected the risk of developing cancer. It is possible that in at least some of the studies adverse health led to greater social isolation rather than the other way round. It is also possible that using social networking sites may lead to reduced social isolation and loneliness, although this possibility is not addressed by the article.

This piece will no doubt stimulate discussion and research, but does not provide proof of an adverse effect of social networking or other technology on people’s health. People who use social networking sites should not be concerned by this article.

Analysis by Bazian

Edited by NHS Website