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Opinion: Health and the retailer mix on UK high streets

The high street is the heart of a local community, a place where all corners of society from young and old to the most and least deprived, come together to engage in retail therapy, socialise with friends or visit cultural attractions.

However, in recent years, many observers have sounded the death knell for UK high streets. The rise of internet, mobile and out of town shopping, combined with the economic downturn, have had a profound impact on the high street landscape. Once prominent high street brands have disappeared, replaced by rising numbers of empty shops and the ‘clustering’ of outlets such as charity shops, fast food takeaways and betting shops.

To revive our ailing high streets, politicians, business leaders and retail experts have come to the same conclusion; the high street must be reinvented. The Royal Society for Public Health believes that health improvement could be an integral part of this, offering consumers an experience beyond retail. This is not only important for the economic growth of our towns and cities, but could be instrumental in tackling avoidable illness.

High street businesses and staff are an untapped resource, with the potential to reach a wide range of people and promote healthy choices, provide opportunities for social interaction and boost mental wellbeing. Despite these opportunities, over recent years we have seen a proliferation of businesses on the high street that, rather than improve health, do the opposite. These include fast food takeaways, betting shops and payday loan shops. There is a strong evidence base demonstrating that a higher number of these outlets encourage the public to visit them more frequently and each poses its own threat to the public’s health.

Concerningly, these businesses are particularly prevalent in areas of high deprivation and poor health outcomes. In a report released last month, we compiled a league table of 70 of the largest towns and cities in the UK, ranking them according to the number of healthy and unhealthy businesses in their core retail boundaries.  All of the top 10 unhealthiest towns and cities were in the bottom 40% for premature mortality in the UK, and four of them were in the bottom 5%.

Many local authorities are undertaking excellent work to improve the health outcomes of their populations; however, without greater powers to curb the rise in ‘unhealthy’ businesses, these efforts risk being undermined.  Local authorities must be given greater planning controls; this could be achieved by removing betting shops and payday lenders from the A2 use class (permission is not needed for conversion of many business types to A2 class), setting health as a condition for the licensing of all types of business and allowing local authorities to set differential business rates. We also call for a limit of 5% to be placed on the number of ‘unhealthy’ businesses allowed to open in an area. This limit would maintain consumer choice, but restrict the clustering of these businesses and encourage greater diversity on the high street.

Through our Health on the High Street campaign, we are also seeking to work with businesses to create a more health promoting environment within shops. Through simple actions, such as removing unhealthy products, like sweets and chocolate, from checkouts and queuing areas and swapping ingredients and cooking methods for healthier alternatives, we can make the healthy choice, the easy choice. Where businesses are reluctant to adopt more health promoting practices, a ‘shove’ approach may be more appropriate, such as cigarette-style health warnings displayed in prominent locations in stores and introducing the mandatory display of nutritional labelling and food hygiene ratings.

We are at a tipping point; without effective action, we face a future of soaring rates of avoidable illness and a healthcare system unable to cope under the strain.  Public health is not solely the responsibility of the medical profession, we must embed healthy lifestyle throughout communities, and the high street is an integral part of this.


Emma Lloyd is Policy and Research executive at the Royal Society for Public Health.


The RSPH Health on the High Street report can be accessed here - https://www.rsph.org.uk/en/policy-and-projects/campaigns/health-on-the-high-street/index.cfm