Perceived status threat and health among White Americans: A scoping review

Previous research on pre-COVID-19 pandemic rising White mortality in the United States suggests that White Americans' perceived decline in relative group status may have influenced worsening mortality. In conjunction with other social and economic indicators, social status threat is one determinant of this population-level health shift, yet it is unclear how perceptions of status threat shape individual health outcomes. Because of this, we sought to identify and synthesize research studies across disciplines that broadly explored how perceived threats to White Americans' social status affect their health. Our research objectives were to (1) examine how status threat (and related constructs) have been measured across the health and social sciences, (2) determine which health outcomes and behaviors are related to status threat, and (3) identify gaps in the existing knowledge base. We systematically searched six multidisciplinary databases. Only 12 studies met inclusion criteria, suggesting that status threat and Whites' health is an understudied topic that warrants continued investigation. Furthermore, there was inconsistency in how threats to status were measured and conceptualized across disciplines. Threat-related indicators evaluated changes in Democratic or Republican vote share, perceived racial treatment, financial status, personal identification with political party affiliation, perceptions of hypothetical "majority-minority" population shifts, racial awareness, and subjective social status. Studies primarily relied on self-rated measures of overall health, mental health status, and social determinants of health. Consequently, there is a gap in the literature concerning which specific health outcomes (besides mortality) are directly affected by status threat. Overall, included studies demonstrated that Whites' can experience negative health effects when they perceive threats in societal conditions, within their interpersonal social experiences, or related to their individual social standing. Moving forward, researchers should consider how Whites' beliefs about their position within social hierarchies potentially affect individual and group-level health outcomes.