Shelter to Survival: Unpacking the Health Impacts of Housing Insecurity Across the Life Course
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThe topic is timely, socially relevant, and full of potential. However, the paper requires major restructuring to realize that potential.
1. Overwhelming amount of information without synthesis. It presents a large volume of content but does not organize, integrate, or synthesize it in a way that supports a coherent argument. The central thread gets lost amid long, dense sections of information. A more structured synthesis would improve readability and make the contribution of the work clear.
2. Weak cohesion between sections. Transitions between sections are abrupt, and the internal logic of the paper is difficult to follow. The writing often feels like a collection of paragraphs rather than a unified narrative.
3. Suggested conclusions not fully developed in the results. Several arguments made in the discussion are not adequately grounded in the findings. Some conclusions feel premature, because the necessary analytical development is missing in the results section.
4. Inconsistent writing and structure. There are notable variations in tone, structure, and clarity throughout the manuscript. Some sections are overly dense, while others are underdeveloped.
Some sections also appear generic, stylistically mismatched, or repetitive in a way that suggests possible reliance on AI-generated text. I recommend reviewing the manuscript very carefully before turning in another version, should an invitation for revision be extended.
Comments for author File: 
Comments.pdf
Author Response
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1. Summary |
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Thank you very much for taking the time to review this manuscript and providing thoughtful and detailed feedback via the pdf file. We appreciate the recognition that the topic is timely and socially relevant, and agree that substantial restructuring was necessary to strengthen the manuscript’s synthesis, coherence, and analytical rigor. In response, we have taken a comprehensive revision focused on: (1) reorganizing the manuscript around a clear, consistent synthesis framework (2) improving transitions and aggregating findings (3) ensuring that all interpretive claims in the Discussion are explicitly grounded in the Results and (4) harmonizing tone throughout the manuscript to improve readability and consistency.
Comment 1: Overwhelming amount of information without synthesis. It presents a large volume of content but does not organize, integrate, or synthesize it in a way that supports a coherent argument. The central thread gets lost amid long, dense sections of information. A more structured synthesis would improve readability and make the contribution of the work clear.
Response 1: Thank you for this insight. We agree with this assessment and have revised the manuscript to strengthen structured synthesis and reduce overly descriptive reporting. The introduction (pages 1–3) was condensed to improve clarity and structure while clarifying the scope and framing. The Results section (page 6-22) was restructured by defining the life-course aligned subsections, with each subsection revised to create a more cohesive and synthesized pattern across studies rather than study-by-study description. As the pdf indicated, repetitive content was removed, and summary synthesis statements were added to make the manuscript’s findings to make the readability more explicit.
Comment 2: Weak cohesion between sections. Transitions between sections are abrupt, and the internal logic of the paper is difficult to follow. The writing often feels like a collection of paragraphs rather than a unified narrative.
Response 2: We appreciate this feedback and have made targeted revisions to improve cohesion and narrative flow. We revised the manuscript’s organizational structure, revised Result section openings to clearly state the purpose and scope of each section and added transition sentences to connect subsections logically. The Results and Discussion were reordered to follow a consistent organizing logic, ensuring that interpretation closely tracks the structure of the findings. Redundancy across sections was reduced, and the consistency was improved based upon the in-text PDF comments.
Comment 3: Suggested conclusions not fully developed in the results. Several arguments made in the discussion are not adequately grounded in the findings. Some conclusions feel premature, because the necessary analytical development is missing in the results section.
Response 3: We agree and have addressed this concern by strengthening Results-to-Discussion alignment. All interpretive claims in the Discussion were cross-checked against the Results to ensure they are explicitly supported by the findings. Where support claims were not sufficiently established, we either (1) added synthesis text and supporting citations in the Results to demonstrate the empirical basis, (2) revised the Results and Discussion language to more appropriately reflect the strength and scope. We also ensured the Discussion had sub-headings to aggregate information more clearly and concisely while addressing the overarching themes found in the Results. We also addressed the pdf comments from each subsection of the Results and Discussion.
Comment 4: Inconsistent writing and structure. There are notable variations in tone, structure, and clarity throughout the manuscript. Some sections are overly dense, while others are underdeveloped.
Response 4: We appreciate this observation and have revised the manuscript carefully to ensure a scholarly voice and clarity. We undertook a full manuscript-wide edit to standardize tone, reduce redundancy, and improve clarity, with particular attention to sections that were overly dense or underdeveloped. We removed or rewrote generic phrasing, ensured that each paragraph contributes directly to the manuscript’s central argument, and improved critical analysis. These revisions were made to strengthen readability, coherence, and authorial consistency. |
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Reviewer 2 Report
Comments and Suggestions for AuthorsThank you for the opportunity to review the submitted manuscript. It addresses the impact of housing conditions, housing security, and housing affordability on mental and physical health across the life course. I consider the core concept to be highly appropriate, namely the life-course perspective and the subsequent search for evidence supporting the assumption that, regardless of the stage of life (from birth, and in fact even the prenatal period, through working age and into post-productive age and, consequently, old age), housing conditions and the quality of the housing stock determine healthy individual development. This applies to both medical problems, such as respiratory diseases (e.g., mould, dampness in housing), and mental health challenges (e.g., depression, chronic stress). In this context, the authors have undertaken valuable work by searching scientific databases for empirical support for their assumptions. As a result, the structure of the manuscript is clear and the text is easy to follow. The submitted manuscript also provides information on the adopted methodology and the successive stages of its development. In the introduction, the authors rightly note that interdisciplinary research has traditionally defined housing insecurity primarily through the lens of affordability, although it should be understood more broadly, taking into account structural constraints and inequalities.
However, in order to improve the quality of the manuscript, I outline several suggestions below:
(1) The introduction presents a very broad—perhaps excessively broad—perspective on the impact of various determinants of housing affordability. It moves from the perspective of the individual, the family, and the household to a macroeconomic or even global perspective. In my view, these perspectives are not clearly linked, or more broadly, there is no smooth and coherent connector between them. Why, for example, are global phenomena (the pandemic), international phenomena of varying intensity and scope (infectious diseases, diarrhoeal diseases, as well as climate change and the migration crisis) discussed, followed by national or, in fact, regional phenomena specific to certain social groups? At this point, the discussion refers almost exclusively to low-income groups in Canada. In light of the above, I recommend greater precision in grouping the themes and an expansion of the literature, particularly in the cited section.
(2) In Figure 1, it is necessary to provide explanations for the special symbols (*) included there. While the reader may infer their meaning, this should be clearly explained and explicitly described.
(3) Considering the structure of Chapter Three (Results), I believe that Table 1, which is placed at the beginning of the chapter, should instead be located at its end, thereby organising and summarising the findings. In addition, references (which may remain grouped, as they currently are) should be provided for each item included in the final analysis. In the section describing the methodology (Figure 1), the authors indicate that this compilation is of a collective nature and does not refer directly to the conceptual framework presented in Table 1.
(4) The authors should clearly explain why they chose a “rapid review” rather than a “systematic review.”
Author Response
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Summary |
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Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.
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Comments 1: The introduction presents a very broad—perhaps excessively broad—perspective on the impact of various determinants of housing affordability. It moves from the perspective of the individual, the family, and the household to a macroeconomic or even global perspective. In my view, these perspectives are not clearly linked, or more broadly, there is no smooth and coherent connector between them. Why, for example, are global phenomena (the pandemic), international phenomena of varying intensity and scope (infectious diseases, diarrhoeal diseases, as well as climate change and the migration crisis) discussed, followed by national or, in fact, regional phenomena specific to certain social groups? At this point, the discussion refers almost exclusively to low-income groups in Canada. In light of the above, I recommend greater precision in grouping the themes and an expansion of the literature, particularly in the cited section.
Response 1
Comments 2: In Figure 1, it is necessary to provide explanations for the special symbols (*) included there. While the reader may infer their meaning, this should be clearly explained and explicitly described.
Response 2:
Comments 3: Considering the structure of Chapter Three (Results), I believe that Table 1, which is placed at the beginning of the chapter, should instead be located at its end, thereby organizing and summarising the findings. In addition, references (which may remain grouped, as they currently are) should be provided for each item included in the final analysis. In the section describing the methodology (Figure 1), the authors indicate that this compilation is of a collective nature and does not refer directly to the conceptual framework presented in Table 1.
Response 3:
Comments 4: The authors should clearly explain why they chose a “rapid review” rather than a “systematic review.”
Response 4: Thank you for this important insight. We revised Section 4.1 (Strengths and Limitations) on page 31 to clarify the rationale for selecting a rapid review, emphasizing the need for timeliness given the rapidly evolving evidence base on housing insecurity and health.
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