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The John Henryism (JH) hypothesis argues that prolonged high-effort coping with chronic psychosocial stressors may be associated with elevated risk for negative health outcomes among those without sufficient socioeconomic resources. Early JH studies found a significant association between high JH, low socioeconomic status, and hypertension among African-Americans. More recently, these findings have been extended to a wide array of health status outcomes, including cardiovascular reactivity, neurohormonal secretion, and negative health behaviors. The present review provides a comprehensive overview of JHs conceptual bases and empirical support. Limitations of the construct are discussed and recommendations are made to guide future theoretical and research efforts in the area.