Social Challenges and Needs in Rural Communities

Dr Hannah Macleod discusses some of the social challenges and needs within Scottish rural communities.
Rural Skye

By Dr Hannah Macleod

“Rural life is not all pretty…social and spiritual issues in today’s rurality: Behind the myth of the rural idyll are many people who struggle with health and social issues”.

This was the brief and billing I was given to facilitate a seminar at this year’s rural church conference. ‘Love the Lord your God with all your heart, with all your soul and with all your mind… Love your neighbour as yourself.’ Matthew 22:37. This was the framework in which we discussed the issues.

My own perspective is that of a GP, working in Skye for 13 years but having grown up in the city. I spent my teenage years living in one of the less salubrious parts of Dundee, above the local betting shop. The soundtrack of each weekend was shouting, singing and sometimes fighting on the street below, as the pubs emptied out. Bottles or fists were banged along the metal shop shutters and commercial bins regularly set on fire. Struggles with isolation, deprivation and addiction existed. This may seem a far cry from the beautiful sounds and scenery of Skye, but under the surface the same issues exist.

As individuals we’re not dissimilar. On the surface, the scenery of our lives can look chaotic or serene, some appear to have it all sorted and some not so much. Underneath we battle the same issues. At the seminar, we focused on just one or two of the many inter-related challenges in the rural context, looking at how we (the church) can bring the love and compassion of Jesus to these situations.


Contributing factors to isolation in personal, professional and church life include travel time, lack of transport links, lack of broadband connectivity and physical distance from family and friends. It could be argued that those from minority ethnic groups, and “incomers”, are perhaps more at risk. Though communities rallied magnificently during the pandemic, it heightened that sense of isolation for many.

Deprivation and dysfunction

The cost-of-living crisis is biting. The government recognises that fuel poverty in rural Scotland is three times that of urban Scotland. Affordable housing is hard to come by and the cost of the weekly grocery shop is eye watering. Employment opportunities in rural areas can look a bit different. It may be work is seasonal, or two jobs are required.

What the Scottish Index of Multiple Deprivation terms ‘access deprivation’ exists in rural areas. This is a recognition of difficulty in accessing services such as healthcare, social care, and childcare.

Sadly, abuse and neglect also exist in the hills and glens, as they do in the streets and lanes. We have a list of ‘looked after children’ at the medical centre and are grateful for the work of the local women’s aid and young carers group.

Health needs

In rural Scotland (with local exceptions) a greater proportion of elderly make up our communities. This naturally creates an increased demand on health and social care services, as well as on families to provide care, where state resources are unable to meet the need. Whatever age, a hospital trip can be a six-hour return journey. If a relative needs 24 hour care, or a lengthy hospital stay, there may be nowhere near home this can be offered, leading to physical separation at great emotional cost to all.

Fewer health care resources across the spectrum are available rurally (hospital beds, specialist nurses, clinics, scans, etc). Third sector organisations are also less resourced.

Addiction, a struggle for many, is often tied in with the issues of isolation, deprivation or dysfunction already touched on. Alcohol deaths are on the rise since the pandemic.

For some in the rural context, anonymity may not feel possible at the local alcoholics anonymous group, or it may be there is no group. Alcohol-free social spaces can be harder to come by out of the city and there’s little specific research on alcohol problems in rural Scotland.

Admitting problems and getting help can be harder and take real courage in a small community, when the perception is that everyone knows everyone’s business. As well as in the context of addiction, this issue of perceived lack of anonymity can create an obstacle to accessing other services offering physical and mental health care, or even just the option of being able to attend church without feeling conspicuous.


What can we, the local church, do about all this?

We know from scripture and personal experience that relationship with Jesus is the only answer to the brokenness in our lives, the only hope, the only place joy can be found. For those of us who have taken hold of Jesus and put our faith in him, that faith and the love in us which comes from Jesus demands action.

Be a church for everyone, where anyone can come in, feel welcome, included, have some space if needed and hear the Truth and the Good News. Rural communities tend to be less diverse than cities, but churches should still reflect the communities they are in. We need to be churches for the isolated, for natives, incomers, second-homeowners, professionals, tradespeople, unemployed, families, singles, young, old, addicts, the unwell, the thriving, caregivers, the vulnerable, the abused and the housebound. All made by God, loved by God and all sinners needing him.

Knowledge of and prayer about local issues are a necessary pre-requisite to addressing them. We need to know the people we live, mix and work with. We are integral parts of our communities but can often end up doing our own ‘church’ things. Rurally, people are a limited resource and there is often no need to reinvent the wheel and have specifically church-run projects when individuals in the church can get involved in the local food bank, befriending scheme, or with other voluntary organisations, serving the community in this way.

We can offer friendship, companionship and co-workmanship, which is mutually beneficial and rewarding, while remembering that oft quoted phrase that ‘people are people, not projects’. There is no agenda in these relationships, other than to love people with the love we have received, to act justly, love mercy and walk humbly, alongside…

Maintaining trust and confidences are an important part of any friendship but perhaps even more so in small rural communities or churches. Avoiding gossip is vital.

As a church we can also provide basic practical help if needed, e.g. transport. Lifts to nursery, school, the doctors, to visit relatives in care homes or hospitals, to collect shopping or go to church. Offer childcare, or a couple of hours respite support for carers. Consider a local Christians Against Poverty group or start a food bank if there isn’t one locally. Perhaps for someone “offline” the church can facilitate internet access. Buildings can and have been vaccination centres, conference centres, somewhere for the local Scouts, Mother and Toddlers’ or AA groups to meet. The church building may be that alcohol-free social space that’s lacking for people to meet day to day.

Rural life may not always be pretty, but the challenges provide the church with opportunity to serve in the name of Jesus and to function as salt and light, as we seek to love our neighbours.