Abstract

The aim is to highlight the health impacts of poor-quality high streets and present evidence for interventions that can improve them to influence health outcomes.

The review provides a rapid assessment of evidence relating to pedestrian-friendly, healthy high streets, with reference to design interventions and street furniture. The review illustrates how a greater understanding of how place and people interact could help realise the potential of our high streets, and contribute to the health and economic gains of our local communities.

Methodology: The most recent evidence on aspects of the high street shown to be health-promoting, and which impact positively on physical and mental health, were searched and synthesised. The research focused on three features: good quality street design, street furniture, and provision of communal spaces – to explore how they can positively impact on social cohesion, and mental and physical health.

Results: The report defines a ‘healthy high street’ as: one that incorporates aspects of the built environment and its uses that have been shown to be health-promoting, impact positively on physical or mental health outcomes of local populations, and promote easy, inclusive access to a wide range of users. High street space needs to be viewed as an existing community asset that has the potential to build and improve social networks, activate community activity, and promote healthy activity.

Conclusions: High streets can become cluttered and difficult to navigate, leading to the exclusion of some groups and increasing risks to pedestrian safety. Traffic, noise and air pollution 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 these issues hinder successful placemaking, have direct and indirect impacts on health, and are unevenly distributed. The unequal distribution of poor-quality built environments contributes to health inequalities in England.