Article Text
Abstract
Background Social and environmental factors, including employment, access to healthy food and the neighbourhood environment have an impact on health outcomes. As places where people work, live, meet and consume, high streets and town centres are influential in shaping health. In recent decades high streets have been in decline, prompting policies at local and national level to revitalise retail environments and support local businesses and communities. The aim of this scoping review is to systematically map evidence on retail environment interventions, to gain a deeper understanding of their possible health and wellbeing impacts. The objectives are to identify different types of interventions and the health outcomes they address; and the mechanism through which interventions are theorised to promote or hinder health and equity.
Methods This scoping review was conducted according to Arksey and O’Malley’s guidance. Peer-reviewed studies in English were identified through searches of academic databases (MEDLINE, Embase, EconLit, Web of Science and Social Policy and Practice) using search terms for relevant initiatives and health and wellbeing outcomes. Additional (grey) literature was identified using citation scanning and online searches on Google and relevant government websites. Studies were eligible for inclusion if they were evaluations of interventions with a significant focus on supporting the retail environment and local economy, reporting on at least one health and wellbeing outcome (including effects on social and environmental determinants of health). Relevant data were extracted and presented descriptively. An interpretive approach was taken to analyse theories of change, presented in a narrative summary.
Results The searches identified 53 peer-reviewed studies and 10 reports. Interventions were categorised in four broad types of interventions: area-based initiatives (n=20), business improvement districts (n=9), business or supply-side incentives (n=27), and demand-side incentives (n=6). Most of the outcomes measured by studies were social (n=33) and environmental (n=14) determinants of health. Some studies measured impacts on physical health (n= 6), mental health and wellbeing (n=4), physical activity (n=2) and food consumption and purchasing (n=20). Studies reported evidence of both improved and worsening outcomes. Theories of change were often under-specified and reductionist. Some authors of the included studies criticised theories for not recognising the importance of context.
Conclusion To our knowledge, this is the first review of literature evaluating the health and wellbeing impacts of interventions aimed at revitalising high street retail environments. Policy-makers need to ensure that interventions are comprehensive and effectively target both economic, health and social outcomes.