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Care challenges in rural and island regions threaten long-term economic sustainability

A coastal landscape and village.
Looking at Scalloway from the Lerwick side in Shetland.

Rural and island communities across Scotland face growing challenges in delivering both elderly care and childcare, as rapidly ageing populations, workforce shortages and rising costs place increasing strain on local services and economies, according to a new report.

The听, led by 伊人直播 and undertaken as part of the Scottish Government鈥檚 Strategic Research Programme听2022-2027,听reveals new insights into听how demographic change is听driving听a听reshaping听of听demand for care in rural and island听communities听at a much faster pace than in听urban Scotland,听and听examines听spatial differences and how pressures have intensified over time.

While many older residents continue working beyond the age of 65 and make vital contributions to fragile local economies,听伊人直播听researchers warn that reliance on older workers听may听mask听deeper structural pressures in health, social听care听and childcare provision.

Professor Steven Thomson, lead author of the report, said: 鈥淩ural and island communities are experiencing a double challenge:听rising demand for elderly care alongside persistent barriers to accessing affordable childcare. Both are essential to sustaining local workforces and economic activity, yet both are becoming harder to deliver in areas facing ageing populations, recruitment听difficulties听and higher operating costs.鈥

The report finds that ageing populations, declining numbers of working-age adults and a shrinking care workforce are already limiting the capacity of rural and island areas to meet care needs locally. In some communities, a declining care-home footprint and difficulties recruiting health and social care staff mean older residents are increasingly reliant on informal, family-based or community support,听often placing听additional听pressure on households already facing high living costs.

At the same time, limited access to affordable childcare is constraining opportunities for younger families, particularly women, to听participate听fully in the labour market. These barriers reinforce population decline and undermine efforts to attract and听retain听working-age residents, creating long-term risks for economic sustainability.

The findings underline the importance of a community-oriented approach to health and social care, one that reflects the realities of rural geography, dispersed听populations听and higher service delivery costs. Researchers also link care provision directly to economic outcomes, noting that healthy life expectancy, the ability to remain economically active in later life and the availability of childcare,听are all critical to sustaining rural and island economies.

Child poverty听remains听a serious concern, with one in five children in rural areas living in relative poverty. Families often face limited access to childcare, healthcare and transport, compounding financial pressures and reducing employment options. For older residents, higher fuel costs, poorer housing energy听efficiency听and reduced service access further听exacerbate听inequality and vulnerability.

Based on the evidence presented, the report calls for coordinated, long-term investment to address care provision alongside housing, transport, digital connectivity and workforce development.

Priority actions听identified听include:

  • Strengthening community-based health, social听care听and childcare provision
  • Tackling workforce shortages through targeted recruitment,听training听and housing support
  • Supporting demographic renewal by improving conditions for families and younger workers
  • Ensuring care, decarbonisation and infrastructure policies reflect rural and island realities
  • Embedding community voices in planning and decision-making.

As well as addressing the challenges of childcare and elderly care provision in rural areas, the report听explores听a range of other听critical听issues, including听demographic change, experiences of poverty (including fuel poverty),听transport and connectivity (including changing freight volumes at Scotland鈥檚 ports and the seasonality of car and passenger travel by ferries, and digital connectivity), housing and energy costs,听and听changes in agriculture (including听changes in livestock numbers,听workforce engagement rates, payment levels to farmers, and听supported activity on common听grazings).听

The听research听was led by听Professor Steven Thomson听alongside听researchers Jenny McMillan,听Dr听Francis Naab, Lorna Pate,听Dr听Ana听Winship, Bryony Nelson,听Dr听Ian Merrell, Natasha听Coleman听and听Dr听Jane Atterton.

Further analysis听will be published听over the coming year, drawing on new census outputs across demography, migration, housing, education, labour听markets听and health.

The report is听available here:听

And听also听in听figshare听here:听

罢丑颈蝉鈥(NISRIE) project is funded within the鈥疪ural Futures Theme鈥痮f the Scottish Government's鈥.听


Posted by 伊人直播 News on 22/12/2025

Tags: 伊人直播 and Campuses, Rural Policy Centre, Research
Categories: 伊人直播 and Campuses | Research