The number of public toilets in England has fallen by 14% in a decade, harming public health and creating vast swathes of lavatory “deserts” and unpleasant environments, a report says.

The analysis by the Royal Society for Public Health found a “significant shortfall” in provision, with 15,481 people for each public toilet in England. That contrasts sharply with Scotland, where there are 8,500 people for each toilet, and Wales, with 6,748.

The analysis was based on 221 freedom of information responses from 309 English councils. The number of toilets was down 14% on 2016.

The RSPH warned that a lack of toilets increased the number of people who urinated in public, creating unhygienic conditions. It also pointed to a potential knock-on effect for high streets because the research suggested that some people avoided going out because of a lack of public facilities.

William Roberts, chief executive of the RSPH, said: “Access to public toilets is a universal need that we all have, and we shouldn’t shy away from talking about it.

“One public toilet per 15,000 people simply isn’t good enough and, without action, that figure will keep rising as we lose more facilities.

“For some people, access to a public toilet can be the difference as to whether they leave the house, for others it can lead to deliberately restricting fluid intake to avoid the needing to use a toilet.

“The effects also go far beyond the individual. Having an insufficient number of public toilets has inevitable unsanitary consequences, creating unpleasant environments that degrade our public realm.

“As a country we can and should be doing better. We need to create public spaces that people want to spend time in, and this means giving local authorities the resources they need to provide the facilities we all rely on.”

The RSPH is calling for new strategic authorities to have a duty to ensure there are sufficient public toilets, backed by funding from central government.

It also said developers must do more, calling for regulations that would require public toilets to be included in any development with non-residential units. Currently, local councils must decide on how many toilets are needed in their area.

The Local Government Association said the lack of public toilets disproportionately affected vulnerable groups, including older people, people with disabilities, those with medical conditions, babies and children and people sleeping rough.

A spokesperson said: “Funding pressures have caused councils to rethink provision. The maintenance of a public toilet could cost a council £25,000 a year, a figure which is greatly impacted by the condition in which they are left by their previous users.

“Vandalism and antisocial behaviour cost councils millions of pounds a year which means councils having to invest into more regular cleaning and better security, meaning that the taxpayer foots the bill for vandalism in this most basic of public provisions.

“Many councils have attempted to address and prevent gaps in provision, by working with businesses to develop community toilet schemes.

“However councils are acutely aware that gaps in provision have opened despite these efforts, for instance where businesses have closed on our high streets.”

A Ministry of Housing, Communities and Local Government spokesperson said: “To help councils provide public services like toilets we’ve made over £78bn available for council finances, with local leaders free to decide for themselves how best to spend the majority of this.”