Socioeconomic Disadvantage among Adolescents: Associations between Having Relatives with Severe Health Conditions, Parental Work Status, and Poor Mental Health
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsDear authors,
I was grateful to be invited to review your paper entitled ‘Socioeconomic disadvantage among adolescents: associations between having relatives with severe health conditions, parental work status, and poor mental health’. The mental health of adolescents is an important and hot topic (especially after the COVID pandemic) that deserves attention. I am pleased that this paper addresses several factors that can affect adolescents’ mental health and can help to prevent and/or improve adolescents’ mental health. Therefore, I think the paper is an interesting and welcome addition to the literature. However, I do have some questions and suggestions for improvement that I would ask you to consider.
Introduction
§ Although the abbreviation RSHCs is used, standing for relatives with severe health conditions, in the Introduction only parents are mentioned. Further on, in the Materials and Methods section, it was explained that the questionnaire asks about “a family member or close person”. Could you explain more clearly who is included in the term relatives or adjust the term to only cover parents/caregivers?
§ It is stated that “The SES among young people 45 may be measured using the parents’ educational level, income, or employment status. In this study, the adolescents’ SES was assessed as having parents that work (PW).” Why did you choose for this measure instead of the others that are mentioned? Please explain.
§ It is mentioned that “We previously showed that adolescents, and especially girls, with several RSHC experiences have significantly increased odds ratios (ORs) for poor mental health as well as for non-suicidal self-injuries.” This paper also investigates the association between RSHC’s (among other variables) and mental health in girls (and boys). Could you explain why you conducted this additional research? Only “further exploration” seems a meager or incomplete reason. And what is the added value of this research compared to the literature (including your own paper)? Maybe some information from the Discussion can be used, because there it is stated that “exploring the associations between psychosocial risk factors, combining adolescents’ experiences with RSHCs and PWS in relation to self-reported poor mental health, has not been applied before to the best of our knowledge”.
§ The terms “adolescents” and “pupils” are used interchangeably and this can cause confusion. Could you choose one term and use this consistently?
Materials and Methods
§ In the paragraph about the response rate (starting with “The 2020 questionnaire was answered by 4159 pupils..”), you explain how many questionnaires were included in the study. I understand that only questionnaires with answers on both key variables RSHC and PWS are included. However, it also is stated that “An additional 153 pupils were excluded due to incomplete data…” thereby referring to missing information about gender, ethnicity etc. Why are these questionnaires excluded? Please explain. Could you also explain why you excluded all these questionnaires instead of imputing the missing data when you have such a big dataset?
§ Mental health was measured by only one and a very broad question, over a fairly long period of time (one year). Isn’t this measure too general and unspecific to define mental health? Please explain why you believe this measure is sufficient and support this with literature.
Results
§ It is mentioned that “Girls reported a more vulnerable situation, with lower proportions reporting enjoying school, feeling safe at home, being happy with leisure, and having dinner daily than boys”. Are these differences statistically significant? Table 1 only reports numbers but no information about statistical differences. And are there any differences between the in- and excluded adolescents? Do you know if the included group is representative of the full group?
Discussion
§ Clear and well-reasoned summary of the results with comparison to the literature.
I hope that my comments will be useful and help to improve your paper. Good luck with your continuing work!
Author Response
Please see attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsDear author(s),
I read in detail your manuscript entitled "Socioeconomic disadvantage among adolescents: associations between having relatives with severe health conditions, parental work status, and poor mental health". As far as the technical elements are concerned, the paper contains all the elements of a scientific paper and follows a clear logic of introducing new information and the presentation of materials and methods.
In the introductory section of the paper, the authors clearly state the reasons for conducting the research. I would suggest to the authors that at the end of the introductory section (after stating the study questions) they should additionally emphasise what research gap is being overcome by this research and what the scientific and practical benefits would be if the research succeeds in answering the research questions. This would certainly increase the reader's interest in reading the paper further, but it would also make it clearer at the beginning of the paper with what intention the authors wrote it.
In the Materials and Methods chapter, the characteristics of the county in which the research was conducted are described in detail, giving the reader a clearer picture of why socioeconomic aspects are particularly important in this area. It also details the process used to conduct the study, emphasises the informed consent and voluntary nature of engaging in this study of both parents and young people, and explains how the constructs included in the study were measured. I really have nothing to add to this part.
The chapter Results is also written very clearly and logically. The authors (especially in the presentation of the logical regression) clearly inform the reader about the most important results and clearly state the percentage of variance explained at the end of each chapter.
The discussion chapter clearly sets out the main findings, to which a possible explanation has been added, as well as practical guidelines for further action (for certain elements there are already interventions in the community that could benefit young people from socioeconomically disadvantaged families). As an only suggestion, I would suggest that the scientific contribution of this study be more clearly emphasised, as well as ideas/suggestions for future research that would give an even better insight into the above issue.
As a result of all the above, in this manuscript I do not encounter any obstacles for it's publication in the Youth Journal. With minor refinements and changes, I propose this paper for publication.
With respect,
Reviewer
Comments on the Quality of English LanguageMinor editing of English language required
Author Response
Please see attachment
Author Response File: Author Response.pdf
