PONE-D-25-48109Household Indebtedness and Well-being: Evidencefrom AustraliaPLOS ONE

Dear Dr. Toffaha,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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After reviewing your study as well as the reviews of two qualified experts, I recommend that you revise your manuscript according to the suggestions of the reviewers. Both reviewers offered relatively minor feedback on suggestions that you should make, and I agree with their suggestions to improve the readability of your manuscript and results. Additionally, in your regression results, I suggest adding metrics to express the overall model fit to give the reader a better since of how important your key variables are to explaining variation in outcomes. After making the revisions suggested by the referees I would be happy to reconsider your manuscript for publication.

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Academic Editor

PLOS ONE

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: I Don't Know

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Reviewer #1: No

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Dear Authors,

Thank you for the opportunity to read your work. The manuscript is clearly written, easy to follow, and the main contributions are well articulated. i noted a few minor issues that could improve clarity.

General notes:

You noted that cDTI is trimmed at 0.5, yet in the abstract/text the FE coefficient moves from 0 --> 1 ( i.e 0% to 100%), which lies outside the observed range. It would be clearer to report the effects per 10 percentage point (pp). Currently the coefficient is reported per 1.0 (i.e., per 100 pp). However, if you change the effect per 10 pp, you estimate the coefficient × 0.10. The following results would occur for Table 4: Health satisfaction FE : −0.284 per 1.0 --> −0.028 per 10 pp.; MCS FE: −4.024 per 1.0 --> −0.402 per 10 pp.; Obesity FE (LPM): 0.022 per 1.0--> +0.0022 per 10 pp (that’s +0.22 pp). Either I would adjust the trimmed threshold or would restate the effects statements accordingly.

It would be helpful to report the effect sizes in SD units, so readers can compare magnitudes across outcomeson a common scale.

Specific notes:

Part 4.2 Regression Results

In Table 4, the pooled obesity model is logistic; thus, the 2.585 coefficient is on the log-odds scale, not percentage points. Please report average marginal effects (AMEs) with 95% CIs (ideally per 10pp change) to express results in percentage points.

Part 4.3 Mortgage Stress

Table 5 appears to treat non-mortgage households as having no mortgage stress.

Problem: "Couldn’t pay the mortgage" is only meaningful for people who have a mortgage. If you include people without a mortgage and code their stress as 0, you’re treating “no mortgage” the same as "has a mortgage and no stress"

To avoid exposure misclassification, please either restrict the sample to mortgage holders or include a mortgage-holder indicator and its interaction with the stress variable, and state this explicitly in the table notes.

Part 4.4 Robustness Check

When relaxing the mDTI trim to 6 or 10 (Table 6), the FE cDTI association with MCS strengthens, while the association with health satisfaction weakens. A more nuanced conclusion seems appropriate: Robustness is strong for mental health and weaker for health satisfaction, with effects remaining in the always-employed subsample.

Kind regards

Reviewer #2: I responded "I Don't Know" to Question #2 (Has the statistical analysis been performed appropriately and rigorously?) because I am not qualified to assess the authors’ statistical methods. For this review, I assumed that the analyses were appropriately designed and executed.

Regarding my “No” response to Question #3 (Have the authors made all data underlying the findings in their manuscript fully available?), the authors explained why this was not possible in the cover document.

This manuscript describes a thoughtfully conceived study that deepens understanding of financial debt as a risk factor for poor health. The authors effectively explained the rationale for their investigation within the context of prior research regarding associations between indebtedness and health. This includes their rationale for focusing on credit card debt, mortgage debt, and occasional inability to make mortgage payments. Their arguments regarding how this study adds to prior research are clear, both in terms of the specific questions they address and why a focus on Australia is distinctive. The study data are derived from five successive waves of a national health survey conducted over a 14-year period and represent substantial numbers of respondents. Their outcome measures (overall health status, mental health status, and obesity) are derived from previously-validated survey questions. Their results are clearly explained and presented. I especially appreciate the presentation and discussion of descriptive findings (Tables 1-3 and accompanying text) in advance of the presentation of modelling results, which grounds and contextualizes the modeling results. In presenting their model findings, they “walk the reader through” the results in a way that successfully explains and interprets the modelling results, both in the results section itself and in summarizing their findings in the discussion section.

I have a few minor recommendations.

It would be helpful to define the term “stock measures” of household liability when the term is first used in the background section, even though the reader can infer its meaning from the subsequent description of debt measures in the methods section.

There appears to be missing text at the start of the 2nd full paragraph on page 2, i.e., the name of the author(s) referred to in the statement, “Building on [17], who used German panel data…”

Tables 4-6 could be more clearly labelled. In their present formats, the reader is entirely dependent on the accompanying text to understand them, and it is not clear what the values in parentheses represent.

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Reviewer #1: No

Reviewer #2: No

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Household Indebtedness and Well-being: Evidencefrom Australia

PONE-D-25-48109R1

Dear Dr. Toffaha,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Meagan McCollum

Academic Editor

PLOS ONE

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