Study finds rise in health-harming shops in deprived areas

Changes on the high streets in the most deprived areas in England are likely to worsen existing health inequalities, new research has said.

Unequal high streets? A spatial analysis of inequalities in health-related amenities in England from 2014 - 2024, published in Social Science & Medicine and funded by The Wellcome Trust, covered nearly 6,800 neighbourhoods across England using ten years of Ordnance Survey data.

Between 2014 and 2024, researchers from Newcastle University and The University of Manchester found that deprived neighbourhoods were more likely to gain potentially health-harming outlets and lose health-conducive amenities, such as pharmacies, than affluent areas.

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Compared with the least deprived areas, the most deprived were more than twice as likely to gain a bookmaker or vape shop, and over 50% more likely to gain a takeaway.

They were also nearly twice as likely to lose a supermarket and a third more likely to lose a public toilet, limiting access to healthy food and basic facilities.

Northern regions were more likely than southern ones to see an increase in takeaways, pawnbrokers, bookmakers and vape shops, with the highest concentrations found in post-industrial cities such as Manchester, Leeds and Birmingham.

The study argued that the clustering of health-harming outlets in already disadvantaged communities creates 'addictive environments' that restrict healthy choices and reinforce inequalities.

It added that local retail mix is often shaped by factors beyond residents’ control, including national economic policy, austerity and patterns of commercial investment.

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While local and national interventions - such as planning restrictions on fast food outlets and tighter regulation of gambling - have shown some positive effects, the study called for more targeted, place-based action to support healthier environments.

This could include involving communities in decisions about their high streets and investing in infrastructure that supports wellbeing.

The authors also cautioned against narratives that stigmatise deprived areas by framing them as 'unhealthy' or in decline.

Pharmacy bodies have issued warnings around business rates rises with the National Pharmacy Association (NPA) warning that many pharmacies will be ‘unable to survive’ in a letter to the Chancellor.

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In her 2025 autumn Budget, Chancellor Rachel Reeves scaled back business rate discounts that have been in place since the pandemic from 75% to 40% and announced that there would be no discount at all from April.