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Are high heels bad for your health? Two experts review the evidence
August 3, 2017 5.35pm AEST
The answer to the question: “Are high heels bad for your health?” may seem obvious to some. There is copious research into the manifold ways that high heels affect their wearers’ well-being, but it is highly fragmented, often focusing on specific health issues. Plus, there is also research that shows benefits to wearing high heels. We decided to take the many factors involved in high heel health into account and conduct the first systematic review of research into both the benefits and harms of high heel wear. We identified 506 individual studies on the issue of high heels and health, screened 27 of them and included 20 publications in our evidence synthesis. Our findings, published in the journal BMC Public Health, showed consistent evidence linking high heel wear to an increased risk of bunions, musculoskeletal pain and injuries to the wearer. Some of these injuries, such as ankle fractures, were serious and required hospital attention. It is important to note, however, that the overall risk of injury is moderate. In some cases, people suffered serious injuries from wearing high heels, but these were not particularly common and the current evidence does not suggest serious cause for alarm. Some studies have suggested a link between high heel wear and osteoarthritis but our review found that the link is inconclusive. It is clear though that frequent wear tends to be more detrimental for long-term health, while the highest and narrowest heels are those that are most linked to serious injuries, such as ankle fractures. One element of high heel wearing that is often ignored in the high heels public health debate, but which we took into account in our study, is the psychological benefits they bring to wearers. Like it or not, high heels are a symbol of modern (heteronormative) female sexuality. We found consistent evidence that high heel wear offers benefits to women in terms of how they perceive their own beauty, how attractive they were to men and also men’s willingness to help them, for example completing a questionnaire or retrieving a dropped glove. So there is a potential dilemma that women face: wearing high heels may increase their attractiveness but it may also be detrimental to their health. Freedom to chooseIt is important that women make their own, well-informed choices regarding whether and how often to wear high heels. Our hope is that, by increasing public awareness about both the positive and negative aspects of wearing high heels, people can make an informed choice. To do so, they will have to navigate pervasive elements of culture that promote high heel wearing as fashionable or an expected part of a dress code. People’s freedom to choose is always affected by social expectations. But, informed by research and advocacy, there has been progress in moving away from the idea that high heels are the only choice for women in smart professional or social situations.  Equal footing. shutterstock.comGiven the evidence that more frequent wear is worse for women’s health, it is especially important that women are not required to wear high heels at work. They, of course, may choose to do so if they wish to (unless there are specific occupational reasons not to allow them, such as in a factory). There has been clear progress regarding companies no longer requiring high heels, and indeed changes of policy by major firms have been reported in the media. Nevertheless, whether or not companies can legally require women to wear high heels as part of a dress code remains a point of confusion. The jurisdiction of British Columbia in Canada brought in legislation to specifically prohibit employers from requiring staff to wear heels. In the UK, the government rejected a similar proposal. But this does not make it legal for companies to require that women wear high heels to work. In fact, the statement released by the government at the time clearly stated that it opposed compulsory high heel wear at work, but felt that the existing Equality Act 2010 precludes this practice in most circumstances. It made clear that it is against the law to discriminate on the grounds of gender – which would generally include requirements that women wear something that is bad for their health if men do not have to. Many people do not know this, however. We’d therefore benefit from further clarification on how the Equality Act specifically relates to high heel wearing or the introduction of specific legislation to prevent compulsory high heel wear in workplaces. Clarity on this matter is important to safeguard the health of women – and indeed any wearers of high heels.
对于某些人而言，“高跟鞋不利于健康吗”这个问题的答案似乎很显然。有很多研究都着眼于高跟鞋对穿戴者身体健康各方面的影响，但却高度碎片化，常常只关注于特定的健康问题。另外，也有研究表明穿高跟鞋有好处。于是我们决定综合考虑高跟鞋健康问题中所涉及到的诸多因素，进行首个关于穿高跟鞋的好处和坏处的系统性综述。 我们找到了506个关于高跟鞋与健康的研究，筛选出了27个，在证据合成中包含了20个研究。我们的发现已经发表在了BMC公众健康杂志上，证据一致表明穿高跟鞋会引起拇囊炎、肌肉骨骼痛和损伤。其中某些伤害，比如踝关节骨折，非常严重，需要到医院就诊 不过值得注意的是，受伤的整体风险只是中等。在某些情况下，人们会因为穿高跟鞋而受严重的伤，但这并不十分常见，当前证据表明高跟鞋并非一种值得警惕的严重祸因。某些研究表明穿高跟鞋和骨关节炎之间有一定联系，但我们的综述发现这一联系并非决定性的。虽然频繁穿高跟鞋对长期的健康不利，但最高的和最窄的鞋跟最容易引发严重的伤害，比如踝关节骨折。 在高跟鞋大众健康讨论中常忽视的一点是高跟鞋给穿戴者带来的心理上的好处，但本研究将此纳入了考虑。不管你喜不喜欢，高跟鞋都是现代女性性征的象征。 我们发现证据一致表明穿高跟鞋在以下几个方面对女性有好处：她们如何感知自身的美丽，她们对男性的吸引力如何，男性有多愿意帮助她们，比如完成调查问卷或者归还丢失的手套。因此女性面临着两难困境：穿高跟鞋可能增加她们的吸引力，但也可能不利于自身健康。 选择自由 女性能在充分了解穿高跟鞋的利弊基础上自由作出是否穿以及多么频繁地穿高跟鞋的选择是很重要的。我们希望通过增强公众对穿高跟鞋的利弊认识使民众合理做出属于自己的选择。 为此，他们需要驾驭流行文化中将高跟鞋视作时尚或者期望服饰语言的元素。人们的选择自由常受到社会期望的影响。但由于相关研究越来越多，高跟鞋是聪明女士的唯一选择这一印象已经逐渐淡化了。 有鉴于频繁穿高跟鞋被证实不利于女性健康，因此不应要求女性在工作时穿高跟鞋。当然，如果女性自己愿意，自然也是可以穿高跟鞋(除非特殊职业不允许女性穿高跟鞋，比如工厂中)。 现在越来越多公司已经不再要求女性穿高跟鞋，媒体上也报道了一些大公司规定的变化。然而，公司能否合法地要求女性穿或不穿高跟鞋仍然令人困惑。加拿大的不列颠哥伦比亚省明确立法禁止雇佣者要求员工穿高跟鞋。 在英国，政府则拒绝了类似的提案。但这并不意味着公司就能合法地要求女性必须穿高跟鞋工作。实际上，政府发布的宣言明确说明反对强迫穿高跟鞋工作，但现有的2010平等法案在大部分情形下又排除了这一做法。这就清楚地表明区别对待不同性别是违法的，比如女性必须穿某些不利于健康的服饰，而男性不需要。 但很多人都不知道这个。因此，进一步解读平等法案如何特别说明这一方面的内容，是很有好处的。明晰这一点对于保护女性以及任何穿高跟鞋的人的健康很重要。
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