Journal of Public Health Medicine 24:77-84 (2002)
© 2002 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
The prevalence of foot problems in older women: a cause for concern
Jill Dawson
Margaret Thorogood
Sally-Anne Marks
Ed Juszczak
Chris Dodd
Grahame Lavis
Ray Fitzpatrick
Jill Dawson, Senior Research Fellow. OCHRAD, School of Health Care, Oxford Brookes University, 44 London Road, Oxford OX3 7PD.
Margaret Thorogood, Reader. Health Promotion Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
Sally-Anne Marks, Research Nurse. Division of Public Health and Primary Care, Department of Public Health, Institute of Health Sciences, Old Road, Oxford OX3 7LF.
Ed Juszczak, Medical Statistician. Centre for Statistics in Medicine, Institute of Health Sciences, Old Road, Oxford OX3 7LF.
Chris Dodd, Consultant Orthopaedic Surgeon. Lower Limb Unit, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD.
Grahame Lavis, Associate Specialist Podiatrist. Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD.
Ray Fitzpatrick, Professor. Division of Public Health and Primary Health Care, University of Oxford.
Address correspondence to Dr J. Dawson. E-mail: jdawson{at}brookes.ac.uk
Background Painful feet are an extremely common problem amongst older women. Such problems increase the risk of falls and hamper mobility. The aetiology of painful and deformed feet is poorly understood.
Methods Data were obtained during a pilot case–control study about past high heel usage in women, in relation to osteoarthritis of the knee. A total of 127 women aged 50–70 were interviewed (31 cases, 96 controls); case–control sets were matched for age. The following information was obtained about footwear: (1) age when first wore shoes with heels 1, 2 and 3 inches high; (2) height of heels worn for work; (3) maximum height of heels worn regularly for work, going out socially and for dancing, in 10-year age bands. Information about work-related activities and lifetime occupational history was gathered using a Life-Grid. The interview included a foot inspection.
Results Foot problems, particularly foot arthritis, affected considerably more cases than controls (45 per cent versus 16 per cent, p = 0.001) and was considered a confounder. Cases were therefore excluded from subsequent analyses. Amongst controls, the prevalence of any foot problems was very high (83 per cent). All women had regularly worn one inch heels and few (8 per cent) had never worn 2 inch heels. Foot problems were significantly associated with a history of wearing relatively lower heels. Few work activities were related to foot problems; regular lifting was associated with foot pain (p = 0.03).
Conclusion Most women in this age-group have been exposed to high-heeled shoes over many years, making aetiological research difficult in this area. Foot pain and deformities are widespread. The relationship between footwear, occupational activities and foot problems is a complex one that deserves considerably more research.
Keywords: footwear, feet, heel, prevalence, aetiology
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