A recent study warned that for one unit increase of perceived racial discrimination, there was a threefold higher risk of coronary arterial calcification, an early sign of coronary heart disease. This study was conducted on Chicago and Pittsburg women.

It is not the first study, and certainly will not be the last study, linking racial discrimination to heart disease, or health in general. However, the theory from discrimination to health is still murky.

Recent psychosocial theory focuses on stress and relates it to physiological illness provoked by perceived discrimination, in addition to actual physical environment (such as worse residential housing) and mistreatment (such as lack or inappropriate medical treatments). However, conservatives such as Sally Satel refuted the discrimination idea that it was because the highly sensitive people were more likely to develop heart disease. One could never be sure whether the perceived discrimination existed or not.

This cynical view is wrong. It reverses the cause-effect direction. The discrimination that minorities perceive may be subtle, but only in the eyes of dominant groups. The existence of discrimination has been recorded by numerous studies. In fact, physicians have always claimed themselves fair, but it has been repeatedly shown that they prescribe different treatments between blacks and whites, even if the diseases and symptoms are the same. Another study used anonymous call to assess the discrimination in real estate. It found that those who pretended to be blacks received higher interest rate and worse house than those who pretended to be whites. The subtle discrimination is not trivial at all.

Because it is not possible to design an experimental study in which people are randomly assigned to different race, whether the perceived discrimination is a real discrimination can not be definitely answered. The debate will go on and on.