RSPH has published a league table ranking 70 of Britain’s major towns and cities by the impact of their high streets on the public’s health and wellbeing. 

The rankings, based on the prevalence of different types of businesses found in the towns’ main retail areas, see Grimsby rated as having the unhealthiest high street, with Edinburgh coming out as the healthiest. This ranking excludes London high streets, which have been ranked separately. See full top and bottom 10 below. 

The league table features in the new RSPH report, Health on the High Street: Running on empty, which follows on from the announcement by the Chancellor of the Exchequer of a package of measures designed to reinvigorate the nation’s High Streets. This is a follow up report to the original RSPH Health on the High Street published in 2015, and assesses changes in British retail areas over the past three years.

The report updates the methodology used in 2015, to reflect the changing face of the British high street, adding off-licences and empty shops to the negative influences on health, and cafes and vape shops to the positive influences.

The top 10 “unhealthiest” British high streets were ranked as:

1. Grimsby
2. Walsall
3. Blackpool
4. Stoke-On-Trent
5. Sunderland
6. Northampton
7. Bolton
8. Wolverhampton
9. Huddersfield
10. Bradford

The top 10 “healthiest” British high streets were ranked as:

1. Edinburgh
2. Canterbury
3. Taunton
4. Shrewsbury
5. Cheltenham
6. York
7. Brighton & Hove
8. Eastbourne
9. Exeter
10. Cambridge 

Average life expectancy for people living in areas with the top 10 healthiest high streets is two and a half years longer than for those in the 10 unhealthiest ranked areas. 

Changes to British high streets that have influenced the rankings include:

• A growth in the number of fast food shops by 4,000 between 2014 and 2017, especially in the most deprived areas, which now have five times more fast food shops than the most affluent areas;
• The number of vape shops has doubled from 1,000 to 2,000 in the past three years;
• The high street vacancy rate has increased from below 7% in 2007 to 11% in 2017.

RSPH is now calling for a range of measures to make British high streets more health-promoting, including:  

• The Treasury to review how businesses taxes are determined to ensure high street shops are not put at an unfair disadvantage compared to online retailers; RSPH polling suggests this is a measure which has widespread public backing with three quarters (75%) believing that business rates should not put high street retailers at an unfair advantage compared to online.
• Facebook and Google to provide discounted advertising opportunities to independent health-promoting businesses.
• Local authorities to make records on vacant commercial properties publicly accessible, supporting ‘meanwhile use’ of vacant shops to keep high streets vibrant.
• All vape shops to ensure all customers who smoke are aware of their local stop smoking service.

Shirley Cramer CBE, Chief Executive, Royal Society for Public Health, said: “While the face of the British high street continues to change, the environmental and economic factors that influence inequalities in health outcomes across the country remain stubbornly intractable. Our Health on the High Street rankings illustrate how unhealthy businesses concentrate in areas which already experience higher levels of deprivation, obesity and lower life expectancy. Reshaping these high streets to be more health-promoting could serve as a tool to help redress this imbalance.

“While we broadly welcome the package of measures announced by the Chancellor of the Exchequer this week, we are concerned that they do not go far enough. Local authorities, who are well placed to make changes, are currently operating with one hand tied behind their backs due to ongoing funding cuts, particularly in some of the more deprived areas that feature prominently in these rankings. Many local authorities are doing good work with the resources they have, but they need to be backed, both financially and with enhanced powers, by central Government if they are to succeed in reshaping high streets for the better.

“The announcement of business rates relief in the budget will be a boost for smaller independent businesses; however, there was no consideration of the unfair advantage online businesses enjoy over the high street, through what is nowadays an outdated means of calculating business rates, based on physical premises alone. Our latest report highlights the impact of online retail, including concerns that this may be one of the factors behind the growth and clustering of empty shops and the devastating impact this has on community wellbeing. We would have preferred to see an overhaul of the business rates system, to ensure there is a level playing field between those ‘real world’ retailers which have a high street presence and provide an important service to support their local communities, and online retailers.”

Welcoming the report, Michael Chang, Project and Policy Manager at the Town and Country Planning Association, said: “We shouldn’t underestimate how important the British high street is to everybody’s daily lives and important contributing role town planners and the planning system have to effect change to healthier high streets. The recommendations highlight the need for greater policy clarity from Government departments so local authorities are able to take more effective action against unhealthy retail outlets. The TCPA welcomes this report and its contribution to ongoing efforts by planners and public health professionals to improve the nation’s health and wellbeing.”

Kieron Boyle, Chief Executive of the Guy’s and St Thomas’ Charity, said: “There are huge opportunities to be creative in improving the nation’s health. This work highlights the important interplay of environmental factors on our health and illustrates how many others, beyond the health and care system, can play a role in supporting people’s wellbeing. As a place-based foundation, our experience has shown us the power of businesses coming up with their own solutions to issues in their local area. For example, our recent Healthy High Streets Challenge supported takeaway outlets to make their food offers healthier, without compromising on taste or price.”