> Small towns will always be more expensive than cities to maintain, this should not mean that small towns should then get less facilities. There are certain s

> Small towns will always be more expensive than cities to maintain, this should not mean that small towns should then get less facilities. There are certain sorts of facilities which will almost never be available alongside small towns. It's not just "expensive" to maintain something like a Level 1 trauma center - if it were lightly utilized it would be economically unviable. It is something that will not exist away from a city. That's an extreme example but even more mundane medical facilities end up being very expensive when you push out into rural areas. That those areas tend to be economically depressed, at least in the US, makes the problem that much more serious.