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Social Media, Peer Groups, and Downstream Health

What is the connection between one’s social network, levels of physical activity, and ultimately their overall health? A 2010 study of peer groups found that hanging out with healthy friends could be the best way keep fit (1). I enjoy working out, but I know not everyone does. For myself and others, it’s usually more enjoyable with company. These days we have more options than ever to connect with others to stay fit, and people are often first making those connections online. From Meetup to Facebook and Instagram, there's something for everyone. However, as a whole in the US we are not getting healthier. More than a third of Americans are obese, and life expectancy in the US continues to decline.

With increased options for not only connection, but entertainment and distractions, our cell phones pose a new challenge to our fitness and our willingness to engage in physical activity. Not surprisingly, a 2013 study by Lepp et. al. found that high-frequency cell phone users had lower cardiorespiratory fitness than low-frequency users (2). Both heavy and light cell phone users attributed the phone as a distraction from engaging in physical activity, however, heavy users were also more likely to engage in other sedentary behaviors (i.e. TV). On the other hand, light users used their cell phones to connect to other active peer groups. So, cell phones can both facilitate physical activity and discourage it, depending upon the user.

Another more recent study looked at the content people were exposed to and its effect on behavior. Essentially, they found that in those who make upward social comparisons, posts of their peers engaged in physical activity and healthy behaviors served a motivator, however in those who tend to make downward social comparisons, there was no effect activity levels (3). Regardless of the intent behind the post, it's important to realize not everyone will be impacted the same way. For some, limited use of online social platforms can be great tool to help connect them healthy groups of people and behaviors.

Heavy use, of course, comes with the risks associated movement limitation. Cell phone use is different than other sedentary behaviors because we take our phones with us everywhere we go, so there is an increased opportunity to “sit and play.” You've maybe heard of a new medical condition sometimes referred to as text neck, and there is research to show that increased cell phone use not only negatively impacts posture, but also respiratory function (4). Respiratory function is hindered by slouching and excessive cell phone use.

High users are likely to be sedentary as well causing poor cardiorespiratory fitness, and thus leading them down the path of other risk behaviors, signs & symptoms, illnesses & injury events, and ultimately, high health costs. The influence of peer groups and social media in regards to cell phone use can go in more than one direction from what we’ve seen here already. In the negative direction, excessive cell phone use and a more sedentary lifestyle can present a variety of health risks. When this persists long enough we may start to see signs such as metabolic changes and body composition. People in this situation start to not feel well, and may at this point start to have low back pain and even tendinopathies (5,6). The costs only rise from here as these individuals may suffer losses in productivity and will need to pay the price of being sick in today’s society of exorbitant health care premiums.

So how do we stay ahead of the problem of cell phones? We are not going to get rid of our cell phones and technology anytime soon, so they will probably need to be part of the solution. This next study I believe is a big step in the right direction. This study from the University of Pennsylvania offered free fitness classes to two groups of people, one organized into an online social network, and a control group who were provided only motivational messages and information about the benefits of exercise (7). Participants in the social network were constantly kept up to date about their peer’s fitness activities and achievements. Although the motivational messages were initially helpful, the motivation provided by social networking was stronger and longer lasting. Interestingly, the social network was effective even though it was anonymous, so the subjects did not know who else specifically was in the network, rather all they knew were that the other members were peers. I'm excited to see where further development of this knowledge takes us.

Secondly, we have got to limit our cell phone use to more healthy levels. A quick search yielded a variety of applications for this very purpose, so I recently started using SPACE to begin to monitor my cell phone addiction. I’m a little worried but also excited to keep my habits in check. And lastly, let’s get more connected. Like I said earlier, we have numerous options when it comes to social platforms, but I wanted to take a moment to talk about one of my favorite new applications: FITT Finder is your local guide for fitness and wellness activities & services. With the app you can explore 100's of free trial passes, classes, social active meetups, and fitness events, making it easy and convenient to find the next workout, and maybe some new friends!


1. Ball, K., Jeffery, R., Abbott, G., McNaughton, S. and Crawford, D. (2010). Is healthy behavior contagious: associations of social norms with physical activity and healthy eating. International Journal of Behavioral Nutrition and Physical Activity, 7(1), p.86.

2. Lepp, A., Barkley, J., Sanders, G., Rebold, M. and Gates, P. (2013). The relationship between cell phone use, physical and sedentary activity, and cardiorespiratory fitness in a sample of U.S. college students. International Journal of Behavioral Nutrition and Physical Activity, 10(1), p.79.

3. Burke, T. and Rains, S. (2018). The Paradoxical Outcomes of Observing Others’ Exercise Behavior on Social Network Sites: Friends’ Exercise Posts, Exercise Attitudes, and Weight Concern. Health Communication, 34(4), pp.475-483.

4. Jung, S., Lee, N., Kang, K., Kim, K. and Lee, D. (2016). The effect of smartphone usage time on posture and respiratory function. Journal of Physical Therapy Science, 28(1), pp.186-189.

5. Shiri, R., Karppinen, J., Leino-Arjas, P., Solovieva, S., Varonen, H., Kalso, E., Ukkola, O. and Viikari-Juntura, E. (2007). Cardiovascular and lifestyle risk factors in lumbar radicular pain or clinically defined sciatica: a systematic review. European Spine Journal, 16(12), pp.2043-2054.

6. Gaida, J., Ashe, M., Bass, S. and Cook, J. (2009). Is adiposity an under-recognized risk factor for tendinopathy? A systematic review. Arthritis & Rheumatism, 61(6), pp.840-849.

7. Zhang, J., Brackbill, D., Yang, S. and Centola, D. (2015). Efficacy and causal mechanism of an online social media intervention to increase physical activity: Results of a randomized controlled trial. Preventive Medicine Reports, 2, pp.651-657.

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