Predictors of heel pain among healthy street vendors in Delhi: a cross-sectional study

Street vendors often engage in prolonged standing and walking, placing excessive mechanical stress on the feet and increasing the risk of heel pain, particularly plantar fasciitis. This study aims to explore the prevalence and contributing factors of heel pain among street vendors in Delhi to inform targeted interventions and improve occupational health outcomes in this vulnerable workforce. A cross-sectional study was conducted among 936 street vendors through purposive sampling recruiting participants from popular vending areas in Delhi with the aid of local vendor association to achieve authenticity and representation. Data collected included demographics, BMI, hours standing, sleep quality, and validated scores for foot function (FFI) and quality of life (SF36). Logistic regression analyzed associations between potential predictors and heel pain. Heel pain was reported by 46.1% of participants (n = 395). There were statistically significant differences between vendors with and without heel pain with respect to age (mean 47.4 vs. 43.6 years), BMI (27.4 vs. 23.8), and daily standing duration (6.2 vs. 5.8 h). Vendors reporting heel pain also had poorer sleep quality, higher Foot Function Index (FFI) scores, and lower SF-36 quality of life scores. In multivariate logistic regression, higher BMI (OR = 1.15, 95% CI: 1.08-1.21), hours of standing per day (OR = 1.19, 95% CI: 1.08-1.30), duration of heel pain (OR = 1.58, 95% CI: 1.38-1.80), and FFI scores (OR = 1.16, 95% CI: 1.09-1.23) emerged as significant predictors. The model demonstrated good discrimination (AUC = 0.79) and explained 56% of the variance (Nagelkerke R²). Heel pain among street vendors is strongly associated with BMI, prolonged standing, and foot dysfunction. Interventions targeting these factors may reduce the burden of heel pain and improve overall quality of life. These results underscore the need for targeted occupational health interventions, including ergonomic education, weight management programs, and foot care strategies, to mitigate the risk of heel pain in this vulnerable workforce.