Racial differences in foot disorders and foot type

Abstract

Objective: To describe racial differences in the frequency of structural foot disorders and pes planus and pes cavus foot types in a large cohort of African American and white men and women ages ≥50 years.

Methods: Of 1,695 Johnston County Osteoarthritis Project participants evaluated for foot disorders/types in 2006-2010, 4 with lower extremity amputation were excluded, leaving 1,691 available for analyses (mean age 69 years, mean body mass index [BMI] 31.5 kg/m(2) , 68% women, 31% African American). The most common foot disorders/types were identified using a validated foot examination. Each foot disorder/type was compared by race using logistic regression, controlling for age, BMI, and sex. Effect modification between race (African American versus white) and age, BMI (categorized as ≥30 kg/m(2) [obese] or <30 kg/m(2) [nonobese]), sex, and education was examined.

Results: Hallux valgus (64%), hammer toes (35%), overlapping toes (34%), and pes planus (23%) were common. Compared to whites, African Americans were almost 3 times more likely to have pes planus and were nearly 5 times less likely to have Tailor's bunions or pes cavus. Among the nonobese, African Americans were more likely than whites to have hallux valgus (adjusted odds ratio [OR(adj) ] 2.01, 95% confidence interval [95% CI] 1.39-2.92), hammer toes (OR(adj) 2.64, 95% CI 1.88-3.70), and overlapping toes (OR(adj) 1.53, 95% CI 1.09-2.13).

Conclusion: Foot disorders are common among adults ages ≥50 years and differ by race. Future research is needed to determine the etiology of foot problems, especially those with racial differences, in order to inform prevention approaches.