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> The best large-scale work I’ve seen finds the average association between overall screen/social-media use and teen well-being is tiny

Can you share the source? The last time I looked the association was both clear and pretty strong, e.g. "There was a linear dose–response association of TSSM and risk of depression. The risk of depression increased by 13% (OR = 1.13, 95%CI: 1.09 to 1.17, p < 0.001) for each hour increase in social media use in adolescents." DOI:10.3390/ijerph19095164

> “Social media” lumps together very different things

HN does this, but the research is usually pretty clear in spelling out they mean FB, Insta, TikTok and so on.

> If you want a lever that actually changes incentives, go after business model & design

I too would like changes in that direction (mostly because adults are also affected negatively by social media), but keep in mind even a non-optimized, strictly chronological feed produces these negative effects, see keyword (and associated studies for) "upward social comparison", i.e. people are always more inclined to post about things that went well or are fun, and thus even a pure chronologically sorted feed produces a warped perception of normal social reality.