The only sizable town of the region is the city of Gisborne, which acts as the main commercial and administrative centre and contains most of the industries. Much of the port's traffic is coastal. Practically all of the inward cargo, motor spirits, coal, cement, and flour, is carried by coastal shipping; whereas half the outward cargo is moved by coastal shipping and half by overseas. In 1960 the principal exports were 7,166 tons of frozen meat, 6,061 tons of grain, 4,737 tons of wool, and 4,078 tons of butter. Over the remainder of the region the rural population is served by a number of small centres, usually located near the coast on small flat alluvial stretches; for example (population figures refer to the 1961 census), Hicks Bay (210), Te Araroa (365), Ruatoria (863), Tokomaru Bay (660), and Tolaga Bay (515). Both Tokomaru Bay and Tolaga Bay are engaged in the coastal shipping trade, and in 1960 handled respectively 1,512 and 1,339 tons of cargo, and both recorded a downward trend in cargo handled during the last quinquennium.

The most striking aspects of Gisborne's relation to the region is the demographic predominance of the urban area, which in 1961 accounted for 57.41 per cent of the total population of the region and 73.62 per cent of the region's total European population. These figures are the key to an understanding of the rather unique socio-economic structure of the region. The East Cape, in contrast to so many other New Zealand regions, still has 43 per cent of its population located in rural districts outside of the Gisborne Urban Area. Half (57 per cent) of that rural population is Maori, and this means that the land ratio of rural Europeans is roughly one person per 162 acres, and for rural Maoris it is one person per 52 acres. The structure is therefore one in which the European population is highly concentrated and urbanised, but it also acts as the dominant element in the economy of the rural areas, despite the fact that it is not in the majority. The proportion of Maoris to the total population ranges from 83.15 per cent in Matakaoa county through to 78.03 per cent in Waiapu, 57.73 in Uawa, and 45.63 in Waikohu county, and for the whole of the four northern counties, Maori population represents 67.06 per cent of the total population. The Maoris remain unurbanised and predominantly agricultural and, though there is little documentation, they live, it would seem, at a level somewhat below that of the Europeans. These contrasting structures are part of an economy characterised by slow growth or even stagnation, but accompanied by a disturbingly high rate of natural increase amongst the Maoris and a culturally disruptive flow of young Maori migrants away from the area.