Contextualizing Trends in Television Viewing and Computer Use Among U.S. Children Aged 5–11 Years, 2001–2018

Abstract Introduction Excessive screen time among children is linked to adverse physical, mental, and developmental outcomes. The putative drivers of increasing screen time among school-aged children in the United States remain unclear. Population-level changes may arise from intracohort change (IC)—change in average screen time across survey cycles—or cohort replacement (CR), as later-born cohorts with different levels of screen time replace earlier-born cohorts. Methods We analyzed nine 2-year National Health and Nutrition Examination Survey (NHANES) cycles from 2001 to 2002 through 2017–2018, including 9,841 children aged 5–11 years old. Screen time was measured as the sum of proxy-reported estimates of daily hours of TV/video viewing and computer use. Using linear and algebraic decomposition techniques, we partitioned total change (TC) in screen time into IC and CR components. Models adjusted for demographic, wellness, family, and food security factors. Results The weighted mean estimated daily screen time increased from 2.95 to 4.26 h (Δ = 1.31;44%). Boys consistently had higher proxy-reported mean screen time than girls. In the unadjusted model, IC contributed positively to the increase in screen time, whereas CR partially offset it. These opposing contributions persisted across all adjustment models. Discussion Combined estimated daily screen time among U.S. children aged 5–11 years increased significantly between 2001 and 2018. Increases within birth cohorts were the main source of this rise, while cohort replacement partially offset it. Differences in screen time across birth cohorts were shaped by changing demographics and family environments.