Is there a dose-response relationship? Investigating the functional form between COVID-19 incidence rates and life satisfaction in a multilevel framework.

While there is plenty of research linking the effects of the global COVID-19 pandemic to a drastic reduction of life satisfaction in the population, there is little information on the functional form of this relationship. Until now, one could suspect that this association is linear and a higher number of COVID-19 infections in a region leads to a continuous decline of satisfaction. However, there are reasons to assume that this interrelation is indeed more complex and deserves further attention. To resolve this question, high-quality panel data of the first wave of COVID-19 from Germany are analysed in a fixed-effect multilevel framework. With information from more than 6,000 respondents (after imputation) nested in 339 federal districts, we estimate linear models with higher-order terms up to the fifth degree of median COVID-19 incidence rates and random intercepts for districts to describe the functional form. The results indicate that even regions with very low incidences are affected and a linear decline of satisfaction is only apparent for rather low incidence levels, quickly reaching a plateau, which is then quite constant, even for higher incidence levels. These findings indicate that at least in rich and industrialized countries like Germany, assuming a strictly linear relation between incidences and change of satisfaction is not appropriate.