We present an audit of public awareness, freedom of choice and health behavior change relating to high heel wear subsequent to a major public awareness campaign in the summer of 2017. Substantial reductions in workplace high heel wear were found, whereby increasingly those who wear high heels regularly at work have freely chosen to do so, although certain issues of social expectations remain in certain sectors. Largely, freedom of choice has greatly increased in workplaces in line with increased public and employer awareness. However, high heel wear has not substantially reduced in social settings, and progress has not been made with social expectation and explicit requirement to wear high heels at social events.

In this perspective piece, we discuss the politics of fashion in the cultural West. We cover issues of social expectation and individual freedom. We comment on where society draws the line with regard to public decency. We also comment on how the approach taken by society to health and public safety issues related to fashion differs markedly from that taken to other similar items.