{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T07:09:15Z","timestamp":1756192155675,"version":"3.40.5"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To explore the correlations\/relationships between foot posture, equity and diversity, employment, and time in Barbie Land.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>A retrospective audit of the Barbie population (or their data from online catalogues) using a customised FEET system. That is <jats:bold><jats:italic>F<\/jats:italic><\/jats:bold><jats:italic>oot posture<\/jats:italic> (flat or equinus); <jats:bold><jats:italic>E<\/jats:italic><\/jats:bold><jats:italic>quity (diversity and inclusion<\/jats:italic> (EDI)); <jats:bold><jats:italic>E<\/jats:italic><\/jats:bold><jats:italic>mployment<\/jats:italic> (fashion vs employed); and <jats:bold><jats:italic>T<\/jats:italic><\/jats:bold><jats:italic>ime period<\/jats:italic> (decade of manufacture).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Setting<\/jats:title>\n<jats:p>Barbie Land (Online Barbie catalogues of doll types).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Participants<\/jats:title>\n<jats:p>2750 Barbies and friends who lived in Barbie Land between 1959 to June 2024.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Main outcome measures<\/jats:title>\n<jats:p>Over time there was a decreased prevalence in equinus foot posture from 100% in the first time period to 40% in the last. Barbie\u2019s flat foot posture had a very strong positive correlation with employment (r\u2009=\u20090.89, 95% Confidence Interval (95%CI) = 0.50 to 1.29), and time point (r\u2009=\u20090.85, 95%CI = \u20090.40 to 1.31), while equinus foot posture had a very strong positive correlation with fashion (r\u2009=\u20090.99, 95%CI\u2009=\u20090.87 to 1.11). Similarly, equity (diversity) had a very strong positive correlation with fashion (r\u2009=\u20090.98, 95%CI\u2009=\u20090.82 to 1.15), and strong positive correlation with employment (r\u2009=\u20090.79, 95%CI\u2009=\u20090.26 to 1.33).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Barbie\u2019s equinus foot posture is directly related to her high heel wearing. Barbie models her footwear choice based on task demands, being flat footed and wearing flat shoes when she needs to work on her feet, be physically active or more stable. Given Barbie is known to reflect societal norms, we contend this is most likely true for most high-heel wearers. While Barbie has moved with the times, it appears footwear health messaging about high heel wearing needs to catch up. Health professionals castigating high heels through public messaging, should remember that emphasising health benefits consistently drives positive behaviour change, over highlighting negative consequences. Barbie clearly makes sensible determinations regarding her body autonomy; high heel wearers should have that same ability.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0323719","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T17:24:26Z","timestamp":1747243466000},"page":"e0323719","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Flat out Fabulous: How Barbie\u2019s foot posture and occupations have changed over the decades, and the lessons we can 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