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. 2025 Jul 1;8(7):e2520360.
doi: 10.1001/jamanetworkopen.2025.20360.

Self-Reported Resilience During the COVID-19 Pandemic

Oluwabunmi Ogungbe  1   2 , Tianyou Wang  3 , Pallavi P Balte  3 , Sarah E Slone  1 , Diane Meyer  2 , Norrina Bai Allen  4 , Russell G Buhr  5   6   7 , Jana A Hirsch  8 , Karen Hinckley Stukovsky  9 , Anna Kucharska-Newton  10 , Kelley Pettee Gabriel  11 , Elizabeth A Regan  12 , Vanessa Xanthakis  13   14 , Carmen R Isasi  15 , Gregory Talavera  16 , Martha Daviglus  17 , Krista M Perreira  18 , Mario Sims  19 , Jose Gutierrez Contreras  3 , Namratha R Kandula  4   20 , Joyce S Lee  21 , Virginia J Howard  11 , Suzanne E Judd  22 , Prescott Woodruff  23 , Victor E Ortega  24 , Amanda M Fretts  9 , Sally E Wenzel  25 , Wanda Phipatanakul  26   27 , Nirupama Putcha  28 , Nadia Hansel  28 , Elizabeth Oelsner  3 , Wendy S Post  2   28
Affiliations

Self-Reported Resilience During the COVID-19 Pandemic

Oluwabunmi Ogungbe et al. JAMA Netw Open. .

Abstract

Importance: Identifying factors associated with resilience during the COVID-19 pandemic can inform targeted interventions and resource allocation for groups disproportionately affected by systemic inequities.

Objective: To examine factors associated with self-reported resilience during the COVID-19 pandemic in racially and ethnically diverse, community-dwelling US adults.

Design, setting, and participants: This cross-sectional study was conducted as part of the Collaborative Cohort of Cohorts for COVID-19 Research (C4R) study, which assessed the associations of the pandemic with self-reported resilience of participants from 14 established US prospective cohorts since January 2021. This report includes participants who responded to the self-reported resilience question on C4R questionnaires. Data was initially analyzed from October 2023 to May 2024, with updated analyses performed from August 2024 to April 2025.

Exposure: Race and ethnicity, behavior factors, health conditions, and social determinants of health measurements accessed before and during the COVID-19 pandemic through cohort visits and C4R questionnaires.

Main outcomes and measures: Self-reported resilience was collected via 1 question (from the Brief Resilience Scale) in C4R questionnaires, "I tend to bounce back quickly after hard times." Participants who answered agree or strongly agree were classified as resilient, and those who reported neutral, disagree, or strongly disagree were classified as not resilient. Modified Poisson regression was performed to estimate prevalence ratios (PRs) and access multivariable-adjusted associations with resilience.

Results: Of 31 045 participants (18 672 [60%] women; 10 746 [34.6%] aged <65 years), 1185 (3.8%) identified as American Indian, 6728 (21.7%) as Black, 293 (0.9%) as East Asian, 6311 (20.3%) as Hispanic, 565 (1.8%) as South Asian, and 15 961 (51.3%) as White; a total of 23 103 participants (74.4%) self-identified as resilient. Compared with White participants, Black and Hispanic participants had higher prevalence of self-reported resilience (adjusted PR [aPR], 1.04; 95% CI, 1.02-1.06; aPR, 1.08; 95% CI, 1.06-1.11; respectively) and American Indian and East Asian participants had lower prevalence (aPR, 0.90; 95% CI, 0.86-0.94; aPR, 0.76; 95% CI, 0.68-0.84; respectively). Higher education, being married or living as married, higher income, and overweight were also associated with higher prevalence of resilience. Being female, having diabetes, and being unemployed were associated with lower prevalence of self-reported resilience. Compared with participants with public insurance only, participants with private insurance had higher prevalence of resilience (aPR, 1.07; 95% CI, 1.03-1.10). COVID-19 vaccination and infection statuses were not significantly associated with resilience. Modification analyses showed important racial and ethnic differences in how factors such as hypertension, marital status, and insurance status were associated with resilience.

Conclusions and relevance: In this cross-sectional study of 31 045 adults, self-reported resilience varied by race, ethnicity, and sociodemographic factors. These findings highlight the complex interplay of individual and social factors in shaping the perception of resilience.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Balte reported receiving grants from National Heart, Lung, and Blood Institute (NHLBI) during the conduct of the study. Dr Allen reported receiving grants from NHLBI during the conduct of the study. Dr Buhr reported receiving grants from National Institutes of Health (NIH) NHLBI during the conduct of the study and grants from NIH/NHLBI, Department of Veterans Affairs (VA) Office of Research & Development (ORD) Health Systems Research (HSR), and NIH National Center for Advancing Translational Sciences (NCATS) and personal fees from Chiesi, Optum, Dynamed, and the American College of Physicians outside the submitted work. Additionally, Dr Buhr is an employee of the Veterans Health Administration. Dr Hinckley Stukovsky reported receiving grants from NHLBI via RTI and Columbia University during the conduct of the study. Dr Pettee Gabriel reported grants from NIH during the conduct of the study and grants from NIH outside the submitted work. Dr Talavera reported receiving grants from Columbia University during the conduct of the study. Dr Daviglus reported receiving grants from the NIH during the conduct of the study. Dr Perreira reported receiving grants from the NIH during the conduct of the study. Dr Kandula reported receiving grants from the NIH, Patient-Centered Outcomes Research Institute (PCORI), and American Diabetes Association outside the submitted work. Dr Lee reported receiving personal fees from Blade Therapeutics, Boehringer Ingelheim, AstraZeneca, Elima, EP15, Gatehouse Bio, Mannkind, Syndax, and Mediar; research support from Pliant Therapeutics Research gift; and serving as a section editor for UpToDate and a chapter editor for Merck, on a data safety monitoring board for United Therapeutics and Pulmovant, and as a medical advisor for Pulmonary Fibrosis Foundation, and other from book chapter editor outside the submitted work. Dr Howard reported receiving grants from NIH/NINDS and NIH/NHLBI (paid to institution) during the conduct of the study. Dr Judd reported receiving grants from NIH during the conduct of the study. Dr Woodruff reported receiving grants from NIH and COPD Foundation during the conduct of the study and personal fees from Roche, AstraZeneca, Sanofi, and AbbVie outside the submitted work. Dr Ortega reported receiving personal fees from Regeneron, and Sanofi; serving as an associate editor for JAMA; and authoring a chapter for UpToDate outside the submitted work. Dr Wenzel reported receiving grants from University of Pittsburgh and research support from AstraZeneca, Boehringer Ingelheim, Genentech, GSK, Sanofi-Genzyme-Regeneron, and TEVA during the conduct of the study and personal fees from Regeneron outside the submitted work. Dr Phipatanakul reported serving as a consultant for Genentech, Novartis, Sanofi, Regeneron outside the submitted work. Dr Putcha reported receiving grants from NIH during the conduct of the study and personal fees from AstraZeneca and Verona Pharma for serving on advisory boards outside the submitted work. Dr Oelsner reported receiving grants from NIH during the conduct of the study. Dr Post reported receiving grants from NIH (paid to institution) during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Associations of Age Groups With Self-Reported Resilience by Race and Ethnicity
Figure 2.
Figure 2.. Associations of Sex With Self-Reported Resilience by Race and Ethnicity
See this image and copyright information in PMC

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