Small Towns: How Do They Work?

Unpopular opinion, but a community with a 1000 people is not a town. These are suburbs of actual towns.

These political boundaries are designed to systematically group people on class, and race.

In reality, unless your town has a hospital and a college, it’s not a town. Why does it exist?

What? So screw rural communities? I live in a town of 33,000 and we don’t have a hospital or a college. Perhaps you are confusing town with city? None of these terms have precise meanings, but a town generally refers to smaller communities. And not all of them are suburbs. I do not live in a suburb.


What Are You Talking About Harrison Ford GIF by Star Wars

That’s just not the case.


Where do you go for medical emergencies?

No, that is not really the case. There are areas in the United States where a town with 1,000 people is several hours’ drive from the nearest “real” town, which might have more like 25,000 people. It’s not a suburb of the larger town at that distance.


The next town over?

I’m pretty sure they still have ambulance service in the region.


There are three hospitals within a 30 minute drive. One is about 15 minutes away. My town is still not a suburb of those towns. Most of them are about the same size. One is a city of about 100,000. But you don’t call towns in outlying areas around small cities like that suburbs because the 100,000 city looks and feels more suburban than urban. I just don’t live in an urban area. I’m an hour from Philly and an hour an a half from NYC. I’m probably classified as being in the greater metropolitan area of one or both of those, but no one would call this a suburb. I live just southeastwest (brain fart) of Lakehurst, NJ, if you want to look at it on a map.


Maybe your opinion is unpopular because it’s a willful disregard of what the words “town” and “suburb” actually mean in the English language.

“Suburbs” aren’t defined by population numbers or amenities, they are defined by their proximity to and relationship with nearby cities. So Beverly Hills (pop. ~36,000) is both a suburb of Los Angeles and a city in its own right, whereas a community of 1,000 people somewhere in rural America could easily constitute a town without being a suburb of any city.


Around here once you’re out a bit from the metroplexes, hospitals are usually at the county level. It can be a problem sometimes. Richer unincorporated areas will sometimes also have a private service to airlift people to a hospital. Poorer rural areas just make do.

This definitely was a pain point during covid.

City hospitals may be 3 or more hours away from dozens of small towns here, all served by a bizarre patchwork of agencies.

Usually these places exist because there’s labor there of some kind so people live and work in the area, sometimes for multiple generations. Not sure how that is more or less deserving of existence than, like, Dallas or Austin.


Jesus Christ. I can see you haven’t spent much time out side of major metropolitan areas.

So, there is this part of America called Rural. It is where the land is primarily used for farming and ranching, growing crops, grazing land for cattle, and areas that isn’t really used for much right now, and allowed to go fallow (sometimes not good for much due to topography, soil, or what is growing there.)

This takes up large swaths of land and you may end up with only a few dozen people for every 10 square miles.

But sprinkled through out those rural areas are small towns that have sprung up over time. They may originally have been places where people would bring their goods to sell, a general store, and a train depot. Now many of them make convenient rest stops and where the Co-op grain elevators are. They don’t have a proper hospital or college. They may have more veterinarians than people doctors. They can be as small as under 100 people, or as large as a few thousand. But they are all over America and can be many miles and hours away from a “real” cities with tens of thousands of people.

There are even more “small towns” that are 30-60 minutes from larger cities, but have <10,000 people that still don’t have an actual hospital or college. But trust me, as having lived half my life in them, they do exist.


It’s weird that this discussion came from the assertion that there are no “real” towns as opposed to “why the hell are there no accessible healthcare options for rural areas under the most disgustingly profitable healthcare system on the planet?”

There are PDs in damn near every town I’ve ever lived in, yet almost none of them had hospitals or even an urgent care facility.


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Tom Delonge Wtf GIF by Justin

Seriously, you need to get out more.


The nearest hospital to us is 40 miles away. That, along with crappy schools and unbelievably bad internet connectivity, is the price of living in the hinterlands. Not complaining, just stating facts. We knew when we moved to our current home exactly what we were getting into. 3 acres of woods a mile from the nearest paved road on a creek with nobody too close by is worth it for us. On most days I can sit in my yard and not hear a car for 2 hours. If I have a heart attack, I’m likely dead. Meh, I’m old, done my time, there are worse ways to go out.


You made that claim once already and were swiftly refuted by several people pointing out that you don’t know what you’re talking about.

Repeating that claim without any evidence to support it doesn’t make you sound more credible, it just makes you sound belligerent.


You seem really stuck on this, and it is simply not true. Educate yourself, por favor.


Some people seem to think that their food grows in the produce section of Safeway and all of America can be cleanly divided into city-states.


Is Cambridge, MA a suburb of Boston or a city?, It has over 100,000 people, a city plan of government, and has a number of well-known colleges and more than one hospital, but it does depend on its proximity to Boston in many ways.

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Do you even America bro?

*ugh I’m so old… that meme could probably vote now.

But seriously while the narrative of “small town America” in the media can be misleading, the economic and structural reality of actual small towns in the US provides rather consistent empirical evidence year by year.


“Suburb” and “city” are not mutually exclusive terms. As I noted earlier, Beverly Hills is both a city unto itself (they have their own mayor and city hall and everything) and also a suburb of Los Angeles.