Dr Eman Zied Abozied et al – Written evidence (HSC0031)

 

High Streets and Health: An Uneven Burden of Decline

 

Contributors:

  1. This submission is a collaboration between academics and policy experts who study the impact of the decline of the high street in towns on residents’ health and wellbeing. The views here are our own. Professor Clare Bambra (PhD, FAcSS) is Professor of Public Health at Newcastle University Population Health Sciences Institute, a National Institute for Health and Care Research (NIHR) Senior Investigator and academic co-director of Health Equity North. Her research focuses on understanding and reducing health inequalities. Dr Eman Zied Abozied is a Research Associate at Newcastle University Population Health Sciences Institute. Her background is in urban planning and spatial analysis, and she is interested in designing healthy, resilient cities and promoting evidence-based decision-making in urban planning and public health. Dr Luke Munford is a Senior Lecturer in Health Economics at the University of Manchester and academic co-director of Health Equity North. He is interested in the role of health in improving economic outcomes, particularly productivity. Professor Adam Todd is a Professor of Pharmaceutical Public Health at Newcastle University School of Pharmacy.  He leads a programme of research that applies pharmaceutical knowledge to prevent disease and reduce health inequalities. Hannah Davies of the Northern Health Science Alliance is a policy and communications expert and Executive Director of Health Equity North.

 

Summary:

  1. This submission examines the definition of the high street, what should be included to meet all the needs of the community and suggestions for increasing future resilience and greater footfall of high streets (questions 1, 2, 7 and 8).  Through urban planning literature we define the high street as a street where people can gather and fulfil their socio-economic needs, and that is easily accessible, vibrant and enables community wellbeing. The specific provision of activities and retail is secondary to the qualities and social purpose of the street itself. One of the defining attributes of the high street is that is has always been in a state of transition in order to serve the developing needs of the community. We highlight the health and wellbeing effects of the decline in the high street as well as the uneven burden of decline, with deprived areas and certain vulnerable groups being harder hit by amenity loss and hostile architecture. To address this, our research project Ghost Towns aims to create a comprehensive survey of amenity change in English towns and cities and explore the link between amenity loss, deprivation, demographics and health and wellbeing. To support high streets’ resilience, we suggest a common-sense approach in creating places for people that is rooted in urban planning theory, supported by health research, and includes suggestions for local government policy support. We recommend that future redevelopment focuses on creating street appeal for people, not cars, and providing tailored support to deprived local authorities and vulnerable populations. Finally, we should centre equity in all aspects of decision making around high streets, by prioritising safety and accessibility and aiming to create attractive public spaces for all.

 

How do you define a high street in a town or small city and what is its purpose? 

 

  1. A high street can be defined through its physical spatial properties and its role in the social fabric of the community. It can be thought of as both the physical and social centre of a community, where people go to fulfil their needs. The primary difference between a high street in a small town and one in a large city is that in a city there may be more than one “centre” while in a town there is usually only one. As defined by Griffiths, the high street is “a distinctive mode of social time–space organisation that in many cases emerged historically and in relation to persistent morphological [spatial] structures”1.

 

  1. High streets have some specific spatial characteristics that set them apart from ordinary streets. In the physical sense, which street becomes the “high street” is determined by the urban morphology (spatial layout) of a neighbourhood and the connectivity of streets to one particular street, which becomes the high street. The concept of a “live centre” – a certain spatial organisation of streets that converge on one “high street” was first coined in 1999 by Bill Hillier and the Space Syntax Laboratory and is based on analysis of spatial layout and corresponding pedestrian movement. The live centre/high street of a community is the “location favoured by and influenced by retail, markets, catering and entertainment, and other activities which especially benefit from passing pedestrian movement” 2,3.

 

  1. The historical emergence of the high street (and a closely related concept, the market square1,4) has occurred over hundreds of years and is subject to physical and socio-economic processes of change. They are considered the centre of the community where people gather to exchange interactions, goods, news, et cetera; the function has not changed, rather the actual components (which specific shops and amenities) change over time5. In fact, one of the defining characteristics of the high street is that it has always been in flux6,7 in order to serve the developing needs of the community.

 

  1. Therefore, the definition of a high street can be thought of as the convergence of the physical spatial fabric of a town to a street where people can gather and fulfil their socio-economic needs; and that is easily accessible, vibrant and enables community wellbeing. It is a place that is one part of a complex socio-spatial system8, where the specific provision of activities and retail is secondary to the qualities and social purpose of the street itself9.

 

What should be included on high streets to meet the needs of the whole community? 

 

The issue: the decline of the high street and its effects on the health and wellbeing of the community

 

  1. The main purpose of the high street is to be the spatial and social centre of the community; therefore, the provision of amenities is not only an economic matter but is also related to the health and wellbeing of residents. Looking outside the retail/non-retail classification, we can categorise amenities as either health promoting (salutogenic) or health reducing (pathogenic). Examples of directly health promoting amenities that are on the high street include community pharmacies, children’s centres, and healthy food outlets. Contrast with health reducing amenities such as fast food outlets, vape shops and tobacconists, alcohol only outlets and bookmakers.  Some amenities are not clearly health promoting or health reducing, rather serve another function altogether. The idea of a “third place”, somewhere to go that is not home or work, is central to the functioning of a community, by enabling social interactions, and can be described as “the anchors of community life”10,11.  Examples of third places include cafes, pubs, libraries, social clubs, and community centres.

 

  1. High streets have been going through periods of unprecedented change for several reasons; from gradual societal changes such as the rise of out of town shopping centres, online shopping and changing consumer behaviours12, to worldwide shocks such as the “retail apocalypse”13 and the COVID-19 pandemic14. However, not all high streets have changed, or declined, in the same way. There is an uneven burden of decline, where the changes in high streets and loss of amenities is strongly linked with socio-economic deprivation. Underused retail units on the high street (Greyfield land) is also associated with deprivation and further urban decay15. Places which suffer this double burden of amenity loss and socio-economic deprivation are more likely to become “left behind” in social and economic development16.

 

  1. Current research shows the decline of both health promoting amenities and third places, as well as the increase of health reducing amenities, is often associated with the socio-economic deprivation of an area15. For example, 40% of pharmacy closures between 2015 and 2022 have occurred in the 20% most deprived parts of England17. The observed decline in pubs18 and libraries19,20 has also been shown to correspond with greater economic deprivation in both England and Wales. On the other hand, it has been found that fast food outlets with the unhealthiest menus are increasing in deprived areas when compared with affluent areas 21.

 

  1. The decline of amenities and the high street as a whole also affects groups of people differently – for example, women, the elderly, pedestrians, and children can experience these changes more acutely.  In older adults, the lack of community spaces (and therefore the inability to participate in the community) leads to social isolation– which has knock on effects on health, increasing the risk of cardiovascular diseases, diabetes and cognitive decline22,23. Women’s perceived safety is impacted by shuttered shop fronts,  lack of lighting and lack of people present on the high street24. People who do not use cars are less able to access high streets – being, quite literally, driven off by vehicular traffic25.

 

  1. As well as this, the lack of friendly architecture, such as seating areas, public toilets, shaded areas, and safe pedestrian routes, create a hostile environment for people wishing to use their high street. This “hostile architecture” again affects groups of people differently – for example people with young children are unable to find public toilets to change them, or the elderly are not able to find somewhere to sit after shopping. This again dissuades large swathes of the community from visiting the high streets and further contributes to a decline in footfall26,27.

 

What can we do about it?

 

  1. While current evidence paints a bleak picture of the uneven burden of the high street’s decline, all is not lost. By revisiting the original purpose of the high street in towns and villages – as a spatial and social heart of the community –we can determine what should be included on high streets to meet the needs of the whole community. We know that some high streets have seen decline, however, there is a lack of data identifying and measuring urban change that captures the deterioration of urban environments over time and space28.

 

  1. Our current project, “Ghost Towns” aims to create a comprehensive survey of amenities in towns over the past decade across all of England, and link the change to deprivation, changing demographics, and health outcomes. Through monitoring change in amenities and studying the links between decline and deprivation, we can provide a baseline measure of which local areas have seen the steepest decline as well as the relationship with the health and wellbeing of the community. If we know where we started from, we can more accurately assess the effectiveness of interventions designed to improve the high street.

 

  1. Our initial research in the literature suggests that we should focus on including health promoting amenities and third places in high streets, for example, spaces to interact with others, while limiting the emergence of health reducing amenities such as unhealthy fast food outlets. There should also be a focus on “friendly architecture” on high streets, as “hostile architecture” damages everyone’s experience of their high street. Provision of seating, shade, public toilets, and pedestrian routes can be used by everyone but are especially beneficial for more vulnerable groups. Amenities can be targeted to attract specific groups such as older adults29 and women24. A rising tide lifts all boats – if we make spaces more accessible it improves the quality of high streets for everyone.

 

What should be done to ensure that high streets being redeveloped now are structurally resilient for future societal changes?  How can spatial planning, street design and layout help to drive greater footfall to high streets? 

 

  1. The high street as the spatial and social centre of the community has existed in different forms for hundreds of years in a constant state of change and adaptation to the needs of the local people. We can reframe the idea of “saving the high street” as supporting the transition to its newest form, rather than a return to a nostalgic ideal of how things were30. We can support the redevelopment of the high street through investing in street appeal, local government support and centring equity in decision making.

 

  1. We can encourage people to visit their high street through innovative spatial design and investing in street appeal for people, not cars. This concept of street appeal for pedestrians is summarised by Carmona: “the more appealing streets are physically for walking and cycling, the more conducive they are likely to be as locations where the social, economic and even cultural life of the city will flourish and where populations will be healthier and perhaps even happier”.  By reducing dependency on the motor vehicle as a mode of transport to high streets, we prioritise the value of intangible qualities and social benefits over retail and car-centric transport31.

 

  1. Carmona’s research in London has shown that by prioritising pedestrians over vehicles, there was a 30% uplift in the physical quality of the street, a 5.7% uplift in retail rental values, a 17% decline in retail vacancy, and “very strong perceptions amongst both everyday street users and local property occupiers that street improvement schemes significantly enhance street character, walkability, ease of crossing, opportunities for sitting, and general street vibrancy.” In practical terms, this can be achieved through extensive pedestrianisation of our high streets, the provision of efficient, frequent public transport and park and ride schemes for those who wish to use vehicles32.

 

  1. Investing in friendly architecture enables high streets to self-sustain footfall as people would be drawn to spend time there, and attracts people who may otherwise feel disincentivised such as the elderly and families with young children. Increased footfall in turn means that there are more people on the street, which in turns increases natural surveillance. Natural surveillance, the “eyes on the street” described by Jane Jacobs in her seminal work The Death and Life of Great American Cities37 is an excellent deterrent for crime and anti-social behaviour, as a busy, vibrant high street is less likely to see incidents of anti-social behaviour than one that is empty and derelict. A drop in anti-social behaviour means increasing feeling of perceived safety, especially for women38, which in turn improves the experience for all, and drives further footfall, and thus the cycle becomes self-sustaining and more resilient. To quote Jane Jacobs, “the sight of people attracts still other people”37.

 

  1. There are also local government policy interventions that could increase future resilience of the high streets. Since 2010, the local government funding structures have been changed to reduce funding from central government and incentivise local councils to raise funding through business rates, council tax and commercial revenue33. One of the main ways that local councils raise money for investment is through business rates, which is a tax on most non-domestic properties on the high street. Currently, local councils only keep around half of the revenue they raise34, but there are pilot areas where the local council keeps 100% of the business rate income. As well as the potential increase in income, this trial gives local areas greater powers and independence from central government and allows them to invest the money as they see fit in their local areas.

 

  1. However, by increasing the business rates that councils can keep, there has been a corresponding reduction in Revenue Support Grant (RSG) that councils receive from central government. This has led to councils of more deprived areas not benefitting from the retained business rates. Newcastle City Council argued that the rate retention scheme benefits wealthier councils and “resulted in a lower level of available funding to distribute towards needs formulae for deprived councils.”35. The Levelling Up, Housing and Communities Committee therefore recommended that “The system of local government finance should both enable councils to increase revenue by growing their tax base and protect those in more deprived areas”36. The future resilience of high streets can be increased by targeting monetary and policy support to areas which most need them, rather than applying blanket policies to all local authorities.

 

  1. To summarise, the future resilience of the high street can be supported through focusing on transition to the newest phase of the high street’s life cycle. Through innovative spatial design, we should invest in street appeal for people and friendly architecture for the whole community to use. We should also target interventions in both street design and local government policy to groups and authorities that most need them, and centre equity in such decision-making.

 

22 March 2024

 

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