Emerging Resident Concerns as Signals of a Paradigm Shift in the Spatial Infrastructure for Integrated Community Care: Focusing on Yeonpyeong Island, a Medically Isolated Declining Region of Korea

Across East Asia, rapid population aging and regional decline threaten the sustainability of rural and island communities. Yeonpyeong Island provides a critical context for examining how spatial infrastructure shapes older residents’ daily challenges. The aim of this study is to identify how older adults evaluate their housing and community environments and to determine whether these perceptions signal a transition toward more integrated and community-based care settings. Using a primary quantitative survey of 102 older residents, supplemented by contextual input from a local representative, the study analyzes how health decline, mobility constraints, and housing obsolescence interact with aspirations for service-integrated and socially connected living. Composite scores for perceived home modification needs remained consistently in the mid-to-upper range (approximately 3.5–4.0 on a 5-point scale). Acceptance of alternative, cohousing-type community housing also remained above the midpoint (approximately 3.5–4.1), reflecting an unusually high level of openness in a setting traditionally characterized by low receptivity to residential change and limited local housing alternatives. Safety risks, poor accessibility, and inadequate facilities function as push factors, while preferences for shared programs, proximity-based reassurance, and integrated hubs operate as pull factors, together signaling readiness for more supportive communal living. By integrating Push–Pull Theory with Environmental Press and Life-Space perspectives, the study contributes theoretically by extending these frameworks to the community scale and empirically by providing resident-level evidence from an under-researched island context. The findings highlight how older adults act as evaluators of their environments, articulating practical signals for spatial restructuring and integrated care planning.