In recent decades, the global surge in the use of digital technology has significantly altered the lives of children, and India is no exception. The rapid proliferation of smartphones, tablets, televisions, and computers has provided children with easy access to education, entertainment, and social engagement through the internet and digital media. However, alongside these benefits, a worrying trend has emerged: the increasing amount of time children spend in front of screens, leading to a more sedentary lifestyle. This shift has profound implications for the physical, mental, and social well-being of children in India.^1-5

Excessive screen time and the resulting sedentary behavior have become a growing public health concern. Children are now at risk of various health problems, including obesity, mental health issues, sleep disturbances, and impaired academic performance. This article aims to explore the rise of screen time among Indian children, its associated health risks, and the public health interventions needed to address this escalating issue.

The Rise of Screen Time Among Indian Children^4-7

Current Trends and Statistics

In recent years, the amount of time Indian children spend on digital devices has increased significantly. Children as young as 3 or 4 years old are regularly exposed to screens, often spending hours on smartphones, tablets, or watching television. As children grow older, their screen time tends to increase, particularly during adolescence, when social media and online gaming become more prominent in their lives.

This trend is further exacerbated by India's growing access to high-speed internet and the affordability of digital devices. In many households, multiple screens are available, making it easy for children to be immersed in digital entertainment at any given time. The rise of social media platforms, online gaming, and streaming services has also contributed to this trend, with children spending long hours on activities that require little to no physical movement.

The COVID-19 pandemic has further accelerated this issue. With schools shifting to online learning and restrictions on outdoor activities, children have spent even more time on screens, not only for educational purposes but also for socializing and recreation. This surge in screen time during the pandemic has led to growing concerns among parents, educators, and health professionals about the long-term health implications of such behaviors.

Key Contributing Factors

Several factors have contributed to the increase in screen time among Indian children:

1. Online Education: The transition to online learning during the COVID-19 pandemic was necessary, but it also led to a dramatic rise in children's screen exposure. Many children spent hours in front of computers and tablets for virtual classes, homework, and educational activities, and these long hours often went uninterrupted, leading to excessive screen use.
2. Entertainment and Social Media: The rise of social media platforms and online gaming has significantly impacted how children spend their free time. Platforms like Instagram, YouTube, and TikTok are designed to capture the attention of young users, keeping them engaged for extended periods. Similarly, online gaming platforms offer immersive experiences that encourage prolonged screen use. These platforms are not only entertainment tools but also spaces for social interaction, leading children to spend even more time online.
3. Urbanization and Technology Access: The increasing availability of affordable smartphones, computers, and high-speed internet across India has made digital devices accessible to even the youngest members of society. In urban and semi-urban areas, children are often surrounded by technology at home and in schools, leading to more frequent and prolonged use of screens.
4. Parental Influence and Lifestyle Changes: With both parents and children increasingly leading technology-driven lives, screen use has become normalized in many households. In families where parents are also engaged with their devices for work or entertainment, children are more likely to follow suit. Moreover, busy urban lifestyles have led to a growing dependence on screens as a form of entertainment and engagement for children, especially when outdoor activities or social gatherings are not readily available.

The Health Impacts of Excessive Screen Time^3,5,7

Excessive screen time, particularly when it replaces physical activity and social interactions, can have numerous negative consequences on the health and well-being of children. These impacts can be categorized into physical, cognitive, behavioral, and social effects.

1. Physical Health Issues

• Obesity: One of the most alarming consequences of excessive screen time is the increase in childhood obesity. Screen time encourages a sedentary lifestyle, reducing opportunities for physical activity, which is essential for maintaining a healthy weight. Children are more likely to engage in mindless snacking while watching television or using digital devices, which often leads to the consumption of unhealthy, calorie-dense foods. The combination of a sedentary lifestyle and poor eating habits creates the perfect conditions for weight gain. Obesity in childhood can lead to serious long-term health problems, including diabetes, heart disease, and joint issues.
• Vision Problems: Spending prolonged hours staring at screens can cause digital eye strain, also known as computer vision syndrome. Children may experience symptoms such as blurred vision, dry eyes, headaches, and difficulty focusing. Long-term exposure to digital screens without breaks may also contribute to the development of myopia (nearsightedness), especially during childhood and adolescence when the eyes are still developing.
• Postural Issues: The frequent use of digital devices, often in improper postures, can lead to musculoskeletal problems. Children who spend hours sitting hunched over their phones, tablets, or computers are at risk of developing back pain, neck strain, and repetitive stress injuries such as carpal tunnel syndrome. Poor posture over long periods can also lead to chronic pain and discomfort, which can persist into adulthood if not addressed.

2. Cognitive and Behavioral Effects

• Impact on Academic Performance: Excessive screen time, particularly on non-educational activities such as gaming and social media, has been linked to a decline in academic performance. Children who spend too much time on screens may experience reduced attention spans, difficulty focusing on tasks, and poor time management. Screen use during study hours often distracts children from their academic responsibilities, leading to lower grades and incomplete assignments.
• Sleep Disruptions: The blue light emitted from screens can interfere with the production of melatonin, the hormone responsible for regulating sleep. Children who use screens late into the night, particularly for gaming, watching videos, or social media, may have difficulty falling asleep, leading to sleep deprivation. Inadequate sleep can affect mood, cognitive function, and overall development, leading to irritability, difficulty concentrating, and impaired learning.
• Mental Health Concerns: Increased screen time has been associated with a higher prevalence of anxiety, depression, and social isolation in children. Social media platforms, in particular, can contribute to feelings of inadequacy and low self-esteem as children compare themselves to the curated, idealized images and lifestyles of others. Children who spend excessive time online are more likely to feel disconnected from real-life relationships, which can lead to loneliness and a lack of emotional support.

3. Social and Emotional Development

Excessive screen time can hinder the development of critical social and emotional skills in children. Face-to-face interactions, which are essential for developing empathy, communication, and emotional regulation, are often replaced by digital interactions on screens. Children who spend more time on screens may struggle with building meaningful relationships and may find it challenging to navigate social situations. Prolonged exposure to digital media can also lead to increased impulsivity, reduced self-control, and difficulty managing emotions.

The Sedentary Lifestyle Problem in Indian Children^2,3,6

Decline in Physical Activity

The increasing use of digital devices has contributed to a sharp decline in physical activity levels among Indian children. The World Health Organization (WHO) recommends that children aged 5-17 engage in at least 60 minutes of moderate to vigorous physical activity each day. However, studies show that many Indian children fall far short of this recommendation, particularly in urban areas where outdoor spaces for play are limited, and digital entertainment is more readily available.

Urbanization has reduced access to safe outdoor spaces, such as parks and playgrounds, leading children to spend more time indoors. Additionally, the allure of digital entertainment, such as gaming and social media, has made sedentary activities more attractive than outdoor play. This decline in physical activity is concerning, as it not only affects children's physical health but also their mental well-being and academic performance.

Physical and Mental Health Consequences

1. Obesity and Related Disorders: The combination of sedentary behavior and poor dietary habits is a major contributor to the rise in childhood obesity in India. Obesity is a risk factor for a range of non-communicable diseases, including diabetes, hypertension, and cardiovascular problems. Worryingly, these conditions are now being diagnosed in younger age groups, creating a significant public health challenge for the country.
2. Psychological Well-being: Regular physical activity has been shown to improve mood, reduce anxiety, and alleviate symptoms of depression in children. In contrast, sedentary behavior exacerbates mental health issues, contributing to higher levels of stress and anxiety. Children who do not engage in physical activity may also experience lower self-esteem and social isolation, further affecting their emotional well-being.
3. Academic Performance: Physical activity has been linked to improved concentration, memory, and cognitive function. Children who engage in regular exercise are more likely to perform better academically than their sedentary peers. Unfortunately, the decline in physical activity due to excessive screen use and sedentary behavior may negatively impact academic success.

Public Health Responses and Interventions

Addressing the growing problem of excessive screen time and sedentary lifestyles requires a coordinated effort from governments, schools, parents, and communities. Several interventions have been implemented to mitigate the negative effects of these behaviors on children's health.

1. Government Initiatives

The Indian government has launched several public health campaigns aimed at promoting physical activity and reducing screen time among children. National-level initiatives have encouraged schools to integrate physical education into their curricula and organize fitness activities to promote a healthy lifestyle. These campaigns emphasize the importance of regular physical activity, balanced diets, and mental well-being in fostering healthy development.

2. School-Based Interventions

Schools play a crucial role in shaping children's daily habits. Many schools in India are now incorporating technology-free hours and mandatory physical education sessions to ensure that children engage in regular physical activity. In addition, schools have introduced "movement breaks" during classes to prevent prolonged sitting and promote physical activity throughout the day. Extracurricular sports activities, fitness challenges, and competitions further encourage students to stay active and healthy.

3. Community-Based Initiatives

At the community level, programs that promote outdoor activities, such as cycling, running, and team sports, are gaining momentum. Local governments and community organizations are working to create safe play spaces and public parks for children to engage in physical activities. These initiatives help create a supportive environment for children to lead active, healthy lives and reduce their dependence on digital devices for entertainment.

4. Parental and Family Role

Parents play a pivotal role in regulating their children's screen time and promoting a balanced lifestyle. Setting clear rules around screen use, encouraging physical activity, and fostering healthy eating habits are essential steps that families can take to ensure their children's well-being. Establishing "screen-free zones" in the home or setting aside time for family activities, such as outdoor games or walks, can help reduce children's reliance on screens. Additionally, parents can model healthy behaviors by limiting their own screen use and prioritizing physical activity and family interactions.

The rise of screen time and sedentary lifestyles among Indian children is a growing public health concern with significant implications for their physical, mental, and social well-being. While digital technology offers many benefits, its overuse can lead to a host of health problems, including obesity, mental health issues, and poor academic performance. Addressing this issue requires a collaborative effort from governments, schools, parents, and communities to promote healthier lifestyle choices.

By fostering a balanced approach to technology use and encouraging regular physical activity, we can safeguard the health and development of India's future generations. Public health interventions that emphasize the importance of physical fitness, mental well-being, and social interaction will play a crucial role in ensuring that children grow into healthy, well-rounded individuals capable of thriving in the modern world.

1. John R, Pokale A, Chutke A, Narula APS, Shinde S, Deshmukh R. Prevalence of excess screen time among secondary school children in rural India. J Prev Med Hyg. 2024 Jan 1;64(4):E457-E462.
2. Dubey M, Nongkynrih B, Gupta SK, Kalaivani M, Goswami AK, Salve HR. Screen-based media use and screen time assessment among adolescents residing in an Urban Resettlement Colony in New Delhi, India. J Family Med Prim Care. 2018 Nov-Dec;7(6):1236-1242. 
3. India Today. How excessive screen time is putting Indian children at risk for multiple disorders [Internet]. 2024 Aug 12 [cited 2024 Oct 15]. Available from: https://www.indiatoday.in/health/story/how-excessive-screen-time-is-putting-indian-children-at-risk-for-multiple-disorders-2580873-2024-08-12
4. Kaur N, Gupta M, Malhi P, Grove S. Screen time in under-five children. Indian Pediatr. 2019;56:773-788.
5. Times of India. Effects of screen time on children and recommended guidelines for screen time [Internet]. 2024 [cited 2024 Oct 15]. Available from: https://timesofindia.indiatimes.com/life-style/parenting/moments/effects-of-screen-time-on-children-and-recommended-guidelines-for-screen-time/articleshow/105727218.cms
6. Paldiwal A, Kabra P, Kawalkar U, Mankar AP, Puri M, Rathod A. Prevalence and predictors of screen time exposure in young children: A descriptive, facility-based study. Prev Med Res Rev. 2024;1(4):179-183.
7. Varadarajan S, Govindarajan Venguidesvarane A, Ramaswamy KN, Rajamohan M, Krupa M, Christadoss SBW. Prevalence of excessive screen time and its association with developmental delay in children aged <5 years: A population-based cross-sectional study in India. PLoS ONE. 2021;16(7):e0254102.
8. Jones A, Armstrong B, Weaver RG, Parker H, von Klinggraeff L, Beets MW. Identifying effective intervention strategies to reduce children's screen time: a systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2021 Sep 16;18(1):126. 
9. Ramsey Buchanan L, Rooks-Peck CR, Finnie RKC, Wethington HR, Jacob V, Fulton JE, Johnson DB, Kahwati LC, Pratt CA, Ramirez G, Mercer SL, Glanz K; Community Preventive Services Task Force. Reducing Recreational Sedentary Screen Time: A Community Guide Systematic Review. Am J Prev Med. 2016 Mar;50(3):402-415. 
10. George AS, George ASH, Baskar T, Shahul A. Screens Steal Time: How Excessive Screen Use Impacts the Lives of Young People. Partners Universal Innovative Research Publication. 2023;1(2):157-177.