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High heels are marketed to children, and some schools encourage children to wear them. 18% of injuries from wearing high heels were in children, and 4% in under-tens, in a 2002-2012 US survey. Concern was expressed about children's use of high heels in a 2016 medical review on high-heeled shoes. A nine-year old is about half an adult's height, and a toddler about a quarter; so, relative to body height, a 2-inch (5 cm) heel on an adult would be a one-inch heel on the nine-year-old, and a half-inch heel on the toddler, though whether this translates to comparable health harms is not known.
Wearing high-heeled shoes is strongly associated with injury, including injury requiring hospital care. There is evidence that high-heel-wearers fall more often, especially with heels >2.5cm high, even if they were not wearing high heels at the time of the fall. Wearing high heels is also associated with musculoskeletal pain, specifically pain in the paraspinal muscles (muscles running up the back along the spine) and specifically with heel pain and plantar calluses (only women tested).
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