Racial differences in foot disorders and foot type




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.


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.


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).


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.