Racial differences in foot disorders and foot type: The Johnston County Osteoarthritis Project

Golightly, Yvonne M, Hannan, Marian T, Dufour, Alyssa B, Jordan, Joanne M (2012); Racial differences in foot disorders and foot type: The Johnston County Osteoarthritis Project'; Arthritis Care & Research; Arthritis Care Res; John Wiley & Sons, Inc.; 2151-4658; http://dx.doi.org/10.1002/acr.21752

Objective.

To describe racial differences in the frequency of structural foot disorders and pes planus, and cavus foot types in a large cohort of African American and Caucasian men and women 50+ years old. 

Methods.

Of 1,695 Johnston County Osteoarthritis Project participants evaluated for foot disorders/type in 2006-2010, four 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 gender. Effect modification between race (African American versus Caucasian) and age, BMI (categorized as ≥30 [obese] or <30 kg/m2 [non-obese]), gender, and education were examined. 

Results.

Hallux valgus (64%), hammer toes (35%), overlapping toes (34%), and pes planus (23%) were common. Compared to Caucasians, 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 non-obese, African Americans were more likely than Caucasians to have hallux valgus (adjusted odds ratio [aOR] =2.01, 95% confidence interval [CI] = 1.39-2.92), hammer toes (aOR=2.64, 95% CI=1.88-3.70), and overlapping toes (aOR=1.53, 95% CI=1.09-2.13). 

Conclusions.

Foot disorders are common among adults 50 years of age or older 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.