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Healthy High Streets: Good place-making in an urban setting

What is a healthy high street?

Healthy high streets can be considered an asset that promotes and improves the health of local residents and the wider local community. They feature good quality design and furniture, providing accessible, safe communal spaces that can be used to create healthier, safer and more cohesive local communities. For optimum health promotion, high streets should:

  • be inclusive of people from all walks of life
  • be easy to navigate, including crossings
  • provide shade, shelter and places to stop and rest
  • be walkable and provide options for cycling
  • have low levels of noise and air pollution
  • provide things to see and do
  • have a health-promoting retail offer
  • ensure people feel relaxed and safe
  • consider the local context of the high street, its features and current use, and how all these factors interact with one another

How high streets can impact negatively on health

Less healthy high streets have high levels of air and noise pollution, cause users to feel or to be unsafe due to crime and degradation, and have non-inclusive design. These factors negatively impact on health directly and through psychosocial pathways (where social factors affect states of mind), leading to a loss of quality of life and to poorer health outcomes.

Specifically, high streets can become cluttered and difficult to navigate, leading to the exclusion of some groups and increasing risks to pedestrian safety. High levels of traffic, noise and air pollution on the high street have direct, negative impacts on health. The rise of out-of-town shopping centres, internet shopping, and car ownership has drawn people away from some high streets. All of these issues hinder successful place-making, have direct and in direct impacts on health, and are not evenly distributed: poor and disadvantaged communities are more likely to live in areas that have poor quality built environments, including local high streets. The unequal distribution of poor-quality built environments contributes to health inequalities in England.

These health inequalities are clearly demonstrated in significant differences in the total life expectancy and healthy life expectancy of the most and least well-off communities in England. Men in the most deprived ward can expect to live 16.5 more years in poor health and 7.4 fewer years overall than men in the least deprived ward. For women, the differences are 11.6 and 4.6 years respectively.

Features of an unhealthy high street are summarised in Table 1, alongside their direct and indirect impacts on health.