Racial differences in foot disorders and foot type

Authors


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/m2, 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/m2 [obese] or <30 kg/m2 [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 [ORadj] 2.01, 95% confidence interval [95% CI] 1.39–2.92), hammer toes (ORadj 2.64, 95% CI 1.88–3.70), and overlapping toes (ORadj 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.

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