New research finds towns and cities in North and Midlands are more likely to have higher concentrations of businesses which may harm the public’s health.

RSPH has published a league table ranking 70 of the UK’s major towns and cities based on the proportion of businesses found in their main retail area that either support or harm the public’s health.

The league table forms part of RSPH’s Health on the High Street campaign which aims to make high streets healthier, by encouraging businesses to take steps to promote health while also giving further powers to local authorities in the areas of planning and licensing.

Based on public and expert opinion, RSPH has identified bookmakers, payday loan shops, fast food outlets and tanning salons as having the most negative impact on health, and pharmacies, leisure centres, and health services as having the most positive impact.

Businesses were scored by over 2000 members of the public* and experts, on the extent to which they encourage healthy choices; promote social interaction; provide access to health advice; and promote positive mental wellbeing. Based on the scoring and the prevalence of these different businesses in each town or city, they were ranked.

Places with the unhealthiest retail areas:

1. Preston
2. Middlesbrough
3. Coventry
4. Blackpool
5. Northampton
6. Wolverhampton
7. Grimsby
8. Huddersfield
9. Stoke on Trent
10. Eastbourne

Places with the healthiest retail areas:

1. Shrewsbury
2. Ayr
3. Salisbury
4. Perth
5. Hereford
6. Carlisle
7. Cambridge
8. Cheltenham
9. York
10. Bristol

RSPH is now calling on the next government, to introduce a range of measures to make high streets more health promoting, including: 

• Local authorities to be given greater planning powers to prevent the proliferation of betting shops, payday lenders and fast food outlets;
• Public health criteria to be a condition of licensing for all types of business;
• Mandatory food hygiene ratings linked to calorie and nutrition labelling for fast food outlets;
• A limit of 5% of each type of business on a high street in order to avoid oversaturation and provide affordable choice;
• Legislation to enable local councils to set their own differential business rates to encourage healthier outlets and discourage those that are detrimental to health.

Shirley Cramer CBE, Chief Executive of RSPH, said: “While our ranking of towns and cities is by no means a reflection on whether these areas are generally healthy or unhealthy, our research does find higher concentrations of unhealthy businesses exist in places which already experience high levels of deprivation and premature mortality. We recognise that businesses investing in High Streets are important for local economies; but this shouldn’t be at any price.  The Five Year Forward View calls for us to move “further and faster” to improve the public’s health. This could be achieved by granting Local Authorities enhanced powers to create a rich mix of health promoting businesses on our high streets and encouraging businesses to promote healthy choices.”

Dr Janet Atherton, President of the Association of Directors of Public Health, said: "Our research shows empowering local authorities to control the total availability of alcohol, gambling and fast food on the high street is a top 10 priority for 91% of Directors of Public Health. The recommendations in this report solidly echo our calls for the government to implement legislative changes and we urge them to bring about these necessary changes to help protect public health."

Matthew Hopkinson, Director of The Local Data Company, said: “These numbers and the towns identified are not surprising. The last five years has seen fundamental structural changes happening with many traditional high street occupiers reducing store numbers and moving out of town. The gaps created have been filled by the likes of bookmakers, payday loan shops, fast food and tanning which RSPH identifies as unhealthy. There have been some exceptions to this where we have seen the number of juice bars and gyms increase significantly but the balance is still very much in what RSPH defines as the unhealthy uses.”