The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults

Samira Mohammadi; Mahmoud Tavousi; Ali Asghar Haeri-Mehrizi; Fatemeh Naghizadeh Moghari; Ali Montazeri

doi:10.1371/journal.pone.0265914

Peer Review History

Original SubmissionSeptember 7, 2021
1 Dec 2021 Decision Letter - Forough Mortazavi, Editor PONE-D-21-28962The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adultsPLOS ONE Dear Dr. Montazeri, 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. According to the reviewers’ comments and my evaluation, the methods and discussion sections need careful attention and must be improved according to the comments. Please submit your revised manuscript by Jan 15 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. 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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. "Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. 3. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. Additional Editor Comments (if provided): Dear authors, Thank you for submitting your manuscript to PLOS ONE. According to the reviewers’ comments and my evaluation, several points needs careful attention. 1. The abstract should be rewritten using a structured format. 2. In the methods section, the authors should describe the sampling method and the procedures for selecting the participants in detail. 3. This study was performed during the covid-19 pandemic. This may have effected on the selection of the sample. 4. The pandemic may have affected both the level of happiness and perceived health. This should be taken into consideration in comparisons with the findings of previous studies in the discussion section. 5. PLS consider the STROBE checklist for reports of observational studies and revise the manuscript taking the following points into account: 6. Describe the setting, locations, and relevant dates, including periods of data collection. 7. Describe any efforts to address potential sources of bias. 8. Explain how missing data were addressed. 9. Discuss limitations of the study, taking into account sources of potential bias or imprecision. 10. Discuss both direction and magnitude of any potential bias. 11. Discuss the generalizability of the study results. 12. Limitations must be further explained in relation to sampling method. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This is an elementary report of a well-known relationship and is OK in itself. but adds little to knowledge. The main rationale is to show this relation in Iranian context. In the context of that goal the authors should compare the strenghts of the correlations with similar studies conducted in other countries. Doing so, they might consider to compare with correlations between happiness and health gathered in the World Database of Happiness, at https://worlddatabaseofhappiness.eur.nl/search-the-database/correlational-findings/#id=-1yD-HsBSlHDfFpgD2EY. This would require that they use item 15 from the OHQ rather than the full scale. The use of the OHQ should be reconsidered anyway. A look at the items shows that it covers a wide range of positive traits rather than happiness in the sense of life-satisfaction. Item 28 is about self-rated health and causes autocorrelation. In the discussion section the authos acknowledge that the correlation may be driven by an effect of happiness on health, but in the conclusion they attribute the correlation to the effects of health on happiness Reviewer #2: The results of this paper are interesting, and can contribute to the literature on happiness and health among adults. However, several revisions are required for this work to be accurately portrayed, received, and interpreted. Below, I have separated my comments into an overall comment. - The first paragraph should include some comparative statistics on figures/statistics from EMRO region countries to provide the context for Iran being similar (in terms of happiness and health). - The validity and reliability of the questionnaire (Oxford standard Happiness Questionnaire & Self-rated health) among the Iranian population should be justified in detail. - In table 1; write the scale of Education & Income. - More discussion about the justification of finding should be provided in this section. The discussion is disorganized and confusing. It is better to summarize your findings firstly and then discuss them separately. - The conclusion is the repetition of what has been said in the text! And need a revision based on results. - The manuscript needs a revision for grammar, typos, and English expressions to improve the readability. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Ruut Veenhoven Reviewer #2: Yes:** Vahid Rashedi [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0265914.r001
Revision 1
17 Jan 2022 Author Response Forough Mortazavi Academic Editor PLOS ONE 12 January 2022 Dear Dr. Mortazavi, PONE-D-21-28962 The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults PLOS ONE Thank you for your e-mail. We are grateful to both reviewers and found their comments very helpful. We have revised the manuscript and now very pleased to submit the revised version for your consideration. All changed are marked in blue and hope you find it satisfactory. Wish you all the best. Yours sincerely Ali Montazeri When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Thank you. Done. 2. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. "Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. This following sentences add to the manuscript. Data Availability The datasets generated for this study are fully available without restriction. 3. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. Done. Ethics statement The National Institutes for Medical Research Development (NIMAD), Tehran, Iran. ethics committee approved the study (IR.NIMAD.REC.l398.228). Due to the study design and all participants gave their verbal consent. Additional Editor Comments Dear authors, Thank you for submitting your manuscript to PLOS ONE. According to the reviewers’ comments and my evaluation, several points needs careful attention. 1. The abstract should be rewritten using a structured format. Done. 2. In the methods section, the authors should describe the sampling method and the procedures for selecting the participants in detail. The following sentences were added to the Methods as requested: To estimate the sample size, according to a national study [30], and based on population density, the country was classified into five categories. Then, samples were selected based on multi-stage sampling from each category. In doing so, one province was randomly selected from each category. Then two cities and two rural settings were randomly selected in each province. Every household within the city and rural areas had the same probability of being sampled. The households to be sampled were selected using systematic sampling within each census section. Finally, sampling units (the individuals) were selected randomly from all eligible persons living in the same household. Informed consent was obtained from each individual after the purpose of the study was explained. Considering the effect size of 1.4, the sample size of 20320 was estimated. However, in practice, 19499 Iranian adults were entered into the study. 3. This study was performed during the covid-19 pandemic. This may have effected on the selection of the sample. The study was carried out just before pandemic. To satisfy the reviewer’s comment we added the following sentences to the first paragraph of Discussion: Although 2020 coincided with the Covid-19 pandemic, and Covid-19 as a health-threatening factor can affect the level of happiness [37], we were fortunate to collect the data before the pandemic began in Iran. The first tow of deaths related to COVID-19 was reported on February 19, 2020, in Iran [38] while we collected the data in early January 2020. 4. The pandemic may have affected both the level of happiness and perceived health. This should be taken into consideration in comparisons with the findings of previous studies in the discussion section. Please see the above. 5. PLS consider the STROBE checklist for reports of observational studies and revise the manuscript taking the following points into account: 6. Describe the setting, locations, and relevant dates, including periods of data collection. Done. This was a national cross-sectional study conducted from 10 January to 20 January 2020 throughout all provinces in Iran. Currently Iran has 32 provinces with over 80 million populations. 7. Describe any efforts to address potential sources of bias. Done. Please see strengths and limitations. 8. Explain how missing data were addressed. Done. Please see strengths and limitations. 9. Discuss limitations of the study, taking into account sources of potential bias or imprecision. Done. Please see strengths and limitations. 10. Discuss both direction and magnitude of any potential bias. Done. Please see strengths and limitations. 11. Discuss the generalizability of the study results. Done. Please see strengths and limitations. 12. Limitations must be further explained in relation to sampling method. Thank you. There was no limitation in relation to sampling method. However, we included a separate section on strengths and limitations. Hope you find it satisfactory. Please see strengths and limitations. Multistage sampling can simplify data collection when we have large, geographically spread samples, and we can obtain a probability sample without a complete sampling frame. However, it can lead to unrepresentative samples because large sections of populations may not be selected for sampling. Since we used multistage sampling, the result might not be generalized to all Iranians. Review Comments to the Author Reviewer #1 Prof. Ruut Veenhoven This is an elementary report of a well-known relationship and is OK in itself. but adds little to knowledge. The main rationale is to show this relation in Iranian context. In the context of that goal the authors should compare the strengths of the correlations with similar studies conducted in other countries. Doing so, they might consider to compare with correlations between happiness and health gathered in the World Database of Happiness, at https://worlddatabaseofhappiness.eur.nl/search-the-database/correlational-findings/#id=-1yD-HsBSlHDfFpgD2EY. This would require that they use item 15 from the OHQ rather than the full scale. Specifically, although the findings add a little to knowledge, the main rationale for the study could be that this relation was explored in the Iranian context. In doing so it was suggested to examine the relationship between item 15 of the Oxford Happiness Questionnaire (I am very happy) and self-rated health and see how the correlation compares with similar findings among other nations. The result showed that the correlation between item 15 and self-rated health is about 0.64 and is very similar with other studies (see S1 Appendix) [36]. The use of the OHQ should be reconsidered anyway. A look at the items shows that it covers a wide range of positive traits rather than happiness in the sense of life-satisfaction. Item 28 is about self-rated health and causes autocorrelation. We agree. However, at this stage it is impossible to reconsider the happiness measurement. However, we added the following statement to the limitation to comply with the recommendation: One should bear in mind that the Oxford Happiness Questionnaire covers a wide range of traits rather than happiness in the sense of life satisfaction [44]. Perhaps in future studies, if we are going to measure happiness in the sense of life satisfaction, there is a need to use an appropriate measure. In addition, item 28 of the Oxford Happiness Questionnaire is about self-rated health, and thus it might cause autocorrelation with the self-rated health measure, although the item 28 and the measure of self-rated health are worded differently. The latter is negative (I do not feel particularly healthy) while the former is positive and askes people to rate their current health. In the discussion section the authors acknowledge that the correlation may be driven by an effect of happiness on health, but in the conclusion they attribute the correlation to the effects of health on happiness. Thank you for your comment. We agree that we made a mistake and thus the paragraph was deleted. Reviewer #2: Dr. Vahid Rashedi The results of this paper are interesting, and can contribute to the literature on happiness and health among adults. However, several revisions are required for this work to be accurately portrayed, received, and interpreted. Below, I have separated my comments into an overall comment. Thank you for your positive evaluation and comments. - The first paragraph should include some comparative statistics on figures/statistics from EMRO region countries to provide the context for Iran being similar (in terms of happiness and health). According to the world happiness report (2017-2019), the highest and lowest happiness scores were for Finland and Afghanistan, respectively. The Islamic Republic of Iran ranked 118th among 153countries. Although happiness score in Iran was lower than some countries in the Eastern Mediterranean Region (EMRO), such as Saudi Arabia, Pakistan, Morocco, but was higher than some other countries including Jordan, Tunisia, and Egypt [6]. One of the most frequently used measures of self-reported health status is a single question asking individuals to rate their overall health on a scale from excellent to very poor. There is widespread agreement that this simple global question provides a useful summary of how individuals perceive their overall health status [7]. The results of a cross-national study that compared health in Egypt, Iran, Jordan, and the United States showed that means and standard deviations of self-rated health by country was (2.79±0.85), (2.99±0.81), (3.06±0.83), and (3.23±0.78), respectively [8]. - The validity and reliability of the questionnaire (Oxford standard Happiness Questionnaire & Self-rated health) among the Iranian population should be justified in detail. Thank you. Both of them were added in detail. Psychometric properties of the Iranian version of questionnaire are well documented. Cronbach's alpha coefficient (measure of internal consistency) and interclass correlation coefficient (measure of stability) were 0.90 and 0.79, respectively. The convergent and divergent validity of the questionnaire were high and acceptable [32]. Validity and reliability of self-rated health measure among Iranian showed acceptable results. The criterion validity showed that the self-rated health and the WHO-5 well-being had positive correlation as expected (r= 0.5, p< 0.001). Additionally, the reliability of the self-rated health, using interclass correlation coefficient (ICC), was found to be 0.83; 95% CI (0.72 to 0.90) [35]. - In table 1; write the scale of Education & Income. The scales were included. Education: year Income: self-reported - More discussion about the justification of finding should be provided in this section. The discussion is disorganized and confusing. It is better to summarize your findings firstly and then discuss them separately. Done. Please see discussion - The conclusion is the repetition of what has been said in the text! And need a revision based on results. Thank you for your comment. The conclusion was revised. It seems that adopting policies to improve public health and placing health on the public agenda could be an effective approach for increasing happiness. - The manuscript needs a revision for grammar, typos, and English expressions to improve the readability. Thank you. The manuscript was copy edited once more. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0265914.r002
27 Jan 2022 Decision Letter - Forough Mortazavi, Editor PONE-D-21-28962R1The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adultsPLOS ONE Dear Dr. Montazeri, 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. Please submit your revised manuscript by Mar 13 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Forough Mortazavi Academic Editor PLOS ONE Additional Editor Comments: Dear authors, Thank you for revising the manuscript according to the reviewers’ comments; however, a few points still remain. Please kindly consider the points raised by reviewer 1 regarding item 28 and auto-correlation. In presenting the results of statistical analyses, please describe how the authors divided the sample into two groups of low and high happiness for logistic regression analyses. This section is in need of further clarification. Also, in the titles of tables 2 and 3, PLS replace 'happiness' with the correct description, i.e. 'Oxford happiness scores’. Regards, [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: (No Response) Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: (No Response) Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: My objection about auto-correlation is not met. The answer that the concerned questions on health were formulated differently does not convince. Without re-analysis of the data I cannot recommend acceptance. Reviewer #2: I read the manuscript with great interest and think the data reported in this study is valuable, and the authors have made all the corrections to the article entitled: "The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults". ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Ruut Veenhoven Reviewer #2: Yes:** Vahid Rashedi [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0265914.r003
Revision 2
12 Feb 2022 Author Response Forough Mortazavi Academic Editor PLOS ONE 1 February 2022 Dear Dr. Mortazavi, PONE-D-21-28962 The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults PLOS ONE Thank you for your e-mail and the comments. We have revised the manuscript and now pleased to submit the second revision for your consideration. Hope you find revisions satisfactory. Wish you all the best. Yours sincerely Ali Montazeri Editor Comments: Please kindly consider the points raised by reviewer 1 regarding item 28 and auto-correlation. Thank you for your comment. The point was responded. Please see reviwer1. In presenting the results of statistical analyses, please describe how the authors divided the sample into two groups of low and high happiness for logistic regression analyses. This section is in need of further clarification. The following sentence was added to the statistical analysis as requested: Logistic regression analyses were performed to assess the relationship between happiness and independent variables, including participants’ health status. As such happiness as dependent variables was categorized into: ‘happy’ (scores ranging from 4 to 6) and ‘unhappy’ (scores ranging from 1 to 3). Also, in the titles of tables 2 and 3, PLS replace 'happiness' with the correct description, i.e. 'Oxford happiness scores’. Thank you. Done. Reviewers'Comments to the Author Reviewer #1 Prof. Ruut Veenhoven My objection about auto-correlation is not met. The answer that the concerned questions on health were formulated differently does not convince. Without re-analysis of the data I cannot recommend acceptance. Thank you for your comment. The correlation between happiness without item 28 and self-reported health examined and now was added to Appendix. Perhaps in future studies, if we are going to measure happiness in the sense of life satisfaction, there is a need to use an appropriate measure. In addition, item 28 of the Oxford Happiness Questionnaire is about self-rated health, and thus it might cause autocorrelation with the self-rated health measure, although the item 28 and the measure of self-rated health are worded differently. The latter is negative (I do not feel particularly healthy) while the former is positive and askes people to rate their current health. However, we did examine this correlation and found the correlation coefficient to be 0.17 (See S1 Appendix). Reviewer #2: Dr. Vahid Rashedi I read the manuscript with great interest and think the data reported in this study is valuable, and the authors have made all the corrections to the article entitled: "The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults". Thank you for comments and time spent to review this paper. Attachments Attachment Submitted filename: Response to Reviewers.2.docx https://doi.org/10.1371/journal.pone.0265914.r004
21 Feb 2022 Decision Letter - Forough Mortazavi, Editor PONE-D-21-28962R2The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adultsPLOS ONE Dear Dr. Montazeri, 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. Please submit your revised manuscript by Apr 07 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Forough Mortazavi Academic Editor PLOS ONE Additional Editor Comments: Dear authors, Thank you for revising your manuscript. Based on comments by reviewer #1 and my own evaluation, an important point raised still remains unaddressed. PLS take note that without the approval of reviewer # 1, the manuscript cannot be accepted for publication. I strongly recommend that you reanalyze the data after removing the items pointed out by reviewer #1. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0265914.r005
Revision 3
27 Feb 2022 Author Response Forough Mortazavi Academic Editor PLOS ONE Thank you for your e-mail and the comments. We have revised the manuscript and now pleased to submit the third revision for your consideration. Hope you find revisions satisfactory. Wish you all the best. Yours sincerely Ali Montazeri Editor Comments: Based on comments by reviewer #1 and my own evaluation, an important point raised still remains unaddressed. PLS take note that without the approval of reviewer # 1, the manuscript cannot be accepted for publication. I strongly recommend that you reanalyze the data after removing the item pointed out by reviewer #1. Thank you. All comments were attended as suggested. The following revisions were applied: 1. Methods (Statistical analysis): Data were explored using descriptive statistics, including frequency, percentage, mean and standard deviation. Logistic regression analyses were performed to assess the relationship between happiness and independent variables, including participants’ health status. However, since some eminent scholars [36] believe that there is an auto-correlation between item 28 and the self-rated health, we did reanalyze the data while item 28 (I do not feel particularly healthy) was excluded from the Oxford happiness score. As such for both with and without item 28 of the Oxford questionnaire, happiness as dependent variables were categorized into: ‘happy’ (scores ranging from 4 to 6) and ‘unhappy’ (scores ranging from 1 to 3). The results expressed as odds ratio and 95% confidence intervals. A significant level was set at P< 0.05. 2. Results: The results are shown in Table 3. In addition, the results obtained from the same analysis when items 28 was excluded are shown in Table 4. The results almost were very similar and no significant difference was observed from the previous analysis except for age 18-24 (OR:1.191, 95% CI, P= 1.038-1.367, p= 0.013) and 6-9 years of education (OR:1.118, 95% CI, P= 1.024-1.221, p= 0.013). 3. Strengths and limitations In addition, item 28 of the Oxford Happiness Questionnaire is about self-rated health, and thus it might cause autocorrelation with the self-rated health measure, although the item 28 and the measure of self-rated health are worded differently. The latter is negative (I do not feel particularly healthy) while the former is positive and askes people to rate their current health. However, as indicated in reanalysis of the data (Table 4), the findings did not show any major differences to our earlier analysis as shown in Table 3. Attachments Attachment Submitted filename: Response to Reviewers.3.docx https://doi.org/10.1371/journal.pone.0265914.r006
7 Mar 2022 Decision Letter - Forough Mortazavi, Editor PONE-D-21-28962R3The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adultsPLOS ONE Dear Dr. Montazeri, 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. PLS cover the reviewer’s comments in three stages of review in detail. Please submit your revised manuscript by Apr 21 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Forough Mortazavi Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: (No Response) ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: In an earlier comment I noted that the the Oxford happiness scale involves an item on health, which causes auto correlation. I advised to recalculate, leaving this item out I also noted that this questionaire covers broader matters than happiness as discussed in the introduction, and advised to calculate correlations for the few items on life-satisfaction separately The authors did not recalculate, but sufficed mentioning these points under limitations. In my view, that is not acceptable Still another point: the authors write Despite the importance of studying the relationship between happiness and health, only a few 81 small-scale studies have been conducted in Iran [21- 24] They are apparently unaware of the 337 findings on this topic listed in the World Database of happiness at https://worlddatabaseofhappiness.eur.nl/search-the-database/correlational-findings/#id=N1iFWn8BRfHHvZHVJh7X ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes:** Ruut Veenhoven [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0265914.r007
Revision 4
8 Mar 2022 Author Response Dr. Forough Mortazavi Academic Editor PONE-D-21-28962 The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults PLOS ONE Thank you for your e-mail and the comments. We have revised the manuscript and now pleased to submit the fourth revision for your consideration. Hope you find revisions satisfactory. Wish you all the best. Yours sincerely Ali Montazeri Attachments Attachment Submitted filename: Response to Reviewers.R4.docx https://doi.org/10.1371/journal.pone.0265914.r008
10 Mar 2022 Decision Letter - Forough Mortazavi, Editor The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults PONE-D-21-28962R4 Dear Dr. Montazeri, 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. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Forough Mortazavi Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes:** Ruut Veenhoven https://doi.org/10.1371/journal.pone.0265914.r009
Formally Accepted
15 Mar 2022 Acceptance Letter - Forough Mortazavi, Editor PONE-D-21-28962R4 The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults Dear Dr. Montazeri: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Forough Mortazavi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0265914.r010

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