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Local solutions to bridge the gaps in service provision for older people in rural and remote areas

Did you know that one in four people in the UNECE region live in rural areas? This is true for almost one in three people over 65 as rural areas experience faster population ageing.

Rural areas are more thinly populated and people are more geographically dispersed than in urban areas. For this reason, transportation and service infrastructures are more difficult and expensive to create and maintain.

As a result, people in rural areas often face greater challenges in accessing services, including health and social care. This is problematic for those older people who need health care and support with activities of daily living when they experience deteriorating health and reduced mobility. When combined with poorer socio-economic conditions, social isolation, and lack of informal support provided by family members and the community, the situation for older people can become precarious.

Incomes and social protection coverage are lower in rural areas where many are self-employed or contributing family workers in the agricultural sector. Many young people indeed migrate to cities for better education and employment opportunities contributing to faster population ageing of rural communities and a reduced pool of people who can stimulate local economies and provide a helping hand when needed.

The latest issue of the UNECE Policy Briefs on Ageing series focuses on the situation of older people in rural and remote areas. It highlights local solutions to tackle challenges in accessing health and social care, the need for enhancing social inclusion, housing and informal care provision to facilitate “ageing in place” and to improve transportation services to enable mobility in rural areas. Projects and initiatives from 14 countries across the region illustrate efforts by local actors to bridge the gaps in service provision, enhance social cohesion and intergenerational ties, and revive local economies.

In Albania for example, mobile mammography units improve the access to basic screening services for breast cancer for older women in remote areas. In Denmark, technology is used to provide expert medical services against the odds of geographical distance. Tele-medical assessment of ulcers has helped municipal home care staff to more efficiently treat patients. They connect with specialists in regional hospitals via the internet for diagnosis and treatment advice.

The project “Village Service” in Austria is a bottom-up initiative in rural and partly alpine Carinthia that aims to mitigate gaps in the regional support structures through volunteer work. Volunteers typically provide assistance in daily life, such as driving older persons to the doctor, doing the grocery shopping or simply visiting them. People in need of help can call the village service staff. Employees then connect them to a volunteer.

Rural cooperatives for proximity services in Spain train unemployed rural women at risk of social exclusion who provide long-term care for older persons. The trainings help these women to turn the skills gained through the informal work that they have traditionally provided in their families into gainful employment thus contributing to job creation and improved service provision in rural areas.

Policy measures need to be flexible and sensitive to local variations in cultural and physical realities to recognize and meet the needs of older persons in rural and remote areas. They can best be designed and implemented at a local or regional level, and need to be supported by higher levels of government. The policy brief therefore calls for stronger collaboration between public and private service providers, and an encouragement of bottom-up, community-led solutions to make services more cost effective and accessible to older people in rural and remote areas. Access to services that will benefit older people will also benefit younger generations and increase the overall quality of life in rural areas.

Read the policy brief on older persons in rural and remote areas.

The full policy brief series can be found at: www.unece.org/population/ageing/policybriefs.