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8 February 1999
High Heels - Lowbrow

More than three-quarters of American women now wear low-heeled, sensible shoes at work, according to a survey revealed today by the American Orthopaedic Foot and Ankle Society (AOFAS). Furthermore, the higher the educational level completed by women, the lower the heel they wear in a fashion shoe.

The survey of 531 women who work outside the home reflected a continuation of the decade-long trend away from high heels. Forty-four per cent of respondents reported wearing "flats" (fashion shoes with heels less than 1 inch) at work, while 30 per cent wore athletic shoes and 17 per cent wore low pumps (less than 2-1/4 inches). Only 2 per cent of women reported regularly wearing shoes with a heel greater than 2-1/4 inches.

"Educational background appears to play a role in footwear choices," said Cherise Dyal, M.D., New York, who co-authored the study. Women who had more than four years of college were more likely than other respondents to wear flats (fashion shoes with heels less than 1 inch). Fifty-eight per cent of women with more than four years of college reported wearing flats, compared to 46 per cent of women with four years of college, 40 per cent with some college and 37 per cent who completed the 12th grade or less.

"Seeing more women make the shift to low-heeled, more comfortable shoes is encouraging," said committee chair Carol Frey, M.D. "If this trend continues we can expect to see fewer shoe-related foot problems in the future."

High heels place undue pressure on the forefoot and have been shown to lead to bunions, hammertoes, heel pain and other foot problems. Pressure on the balls of the feet increases with heel height, and a 3-inch heel creates significantly more stress on the forefoot than a 1-inch heel.

The AOFAS study results indicate that the higher the heel most commonly worn, the greater the percentage of foot problems reported. The highest percentages of bunions, calluses, neuromas and ingrown toenails were reported in women who most commonly wore a heel height over 2-1/4 inches.

Toe The Line At The AOFAS website

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