The life and death of the Canadian small town

Neoliberal capitalism isn't compatible with small and rural communities. At some point, we either face that fact or we simply let them all die.

The climax from the movie Follow That Bird, filmed on the main drag of my small home town of Georgetown, Ontario

Does every rural community in Canada need an emergency room?

We’re living in tough economic times and we have to ask ourselves serious questions: is it really necessary for small towns to have a place where people can go when they think they’re having a heart attack? Or to be treated after falling off of their roof hanging Christmas lights? Or to see a doctor the moment they’ve started pissing blood?

Maybe it’s time that we’re honest with ourselves. In today’s globalized economy, there’s just no room for a small town’s needs. They are too inefficient.

But then again, what is a town if can’t serve the needs of the people who live there? What good is being in a place if you must go to other places to fulfill a part of your life? People commute all the time, though. It’s normal to move from home to work and pass through at least one set of town limits. Besides, my bedroom community is too small to have the kind of job I’m looking for. I can go to the ER on my way home, if I can still drive.

Does every rural community in Canada need an emergency room, asks a recent CBC article by Julie Ireton. Ireton’s question made me wonder: does every rural community need mail service? Radio broadcasts? Hair dressers? Maybe they don’t really need a library or a community centre, a public pool or a bowling alley. Malls are big town things, small towns certainly don’t need a mall. Maybe not even a school … not too many kids live around here any more anyway.

What are we even doing here?

2.

For 52 years, my Nonna was an operating room nurse in Timmins, Ontario. The hospital loomed large in my family, with cousins and aunts who also worked there, and then volunteered there. Timmins isn’t a small town. It’s a proper city. If you ever talk with someone about Timmins, chances are that if you’ve exhausted the conversation about gold mining, you get to the point where they tell you that in area, Timmins is probably the biggest city in Canada. Like the other largest cities — La Tuque, Val d’Or, Sudbury — the size is a function of the surrounding industries. It’s industry that has given these cities their famous sizes, even if population reaches into the official realm of “tiny.”

But Timmins is not tiny. At 44,000 people, it’s a city hub for northeastern Ontario. And yet, it has seen, over the years, many services slowly leave the town to parts further south (Sudbury, mainly). Many healthcare services have fled south — cancer treatments, lab services — and in going, have pulled jobs out of Timmins. Despite that Timmins isn’t Matheson, Kirkland Lake or Iroquois Falls, even this small city can’t hold onto essential health services.

If you google “Hospital Labratory Timmins” nothing comes up because there are no labs in Timmins any longer. I remember my Nonna telling me that they used to have local lab services. They used to be able to do tests locally. At some point, someone like Ireton asked the question: do we really need lab services in Timmins? Now, everything is sent to Health Sciences North in Sudbury to be tested. With the labs closed, so too went the jobs.

Lab testing in Canada has become overwhelmingly private and for-profit. This past summer, LifeLabs was sold by OMERS, a public sector pension fund, for more than one billion dollars. The buyer was an American, publicly traded company called Quest Diagnostics. They are expecting to make just under $10 billion in profits in 2024.

$10 billion in profits just for testing people’s blood to let them know whether or not they have leukemia.

Of course, no community-based lab could compete with this. The economies of scale that Quest Diagnostics can acheive could never be realized by a small public lab in a small city. It was inefficient for Timmins to have a lab. It was inefficient for Timmins and so many other towns and cities, to have a scientific operation in town that could attract chemists and technitions, secretaries and administrators to live there. It was more efficient for blood work to be sent out a few times per week, be driven for 350 kilometres and get into the queue of testing at a lab serving most of northwestern Ontario.

Of course, in the abstract, we could ask ourselves whether or not a small town needs an ER. But when medical facilities close, we don’t just lose a place to go when we break our ankle. We also lose all the jobs and spin-off jobs that are associated with any industry. Inhalotherapists. Pharmacists. X-ray techs. Trauma experts. Fewer jobs means fewer reasons for people to stay or to come. Fewer jobs means fewer opportunities for children to grow up and work in their chosen field. Fewer jobs means fewer positions for spouses to take when their loved one does find a job. And the downward spiral keeps going down.

3.

It’s hard to think of a modern structure that is as opposed to capitalism in its very existence as the small town. Capitalism adores economies of scale. If you can make fifty gloves in one hour with one technique, you innovate until you can make 500 gloves in one hour with new techniques. Scale up. Get big. Buy out your competition or be bought out. And then centralize, lay off, tighten the belt. All in a day’s work.

For example: If you order apples through Uber Eats from the Foodland in Stayner Ontario, you will pay $4.59 for a bag of apples that will have about nine apples in it. Plus delivery charges and fees, your bag of apples will climb to $17.53 (which is silly because surely you will pick up more than just apples, but hey, I made an Uber Eats account just to see the total). Now, if you decided instead that you wanted 50 metric tonnes of apples, which would equal a huge quantity of apples (50,000), and you ordered them wholesale through Alibaba, you’d pay between $200 and $400. I couldn’t get the shipping cost as I’d have to negotiate that with Alibaba. That is a difference in cost of about $25,000 for the individual bags verses an average of $300 for the apples in bulk. Every resident in Stayner would get 10.8 apples.

But small towns by their very nature are allergic to economies of scale. They can’t make bulk purchases for things in the way that a larger city can. Roads cost more to build, buildings cost more to construct. Projects are smaller so profits have to be increased to make it worth the developer’s time. Factories want access to eager workers. That’s hard when the town’s population is just 3000 and most people already have jobs plus the vacancy rate is less than zero …

4.

Ireton’s article about small town ERs identifies the overwhelming main culprit for ER closures: nurses. A lack of nurses was the reason for why 85% of Ontario ERs temporarily closed down. A lack of nurses is an easy problem to fix. You just need to hire more nurses. This is an especially easy fix because in small towns and rural communities, out migration can be a difficult problem to solve. Hire more nurses, staff your healthcare centres better and before you know it, you have population stability and possibly even growth.

You can do this for a lot of industries. There are jobs and spin-off jobs connected to any large employer. In 2018, Aaron Hutchins took the pulse of rural Canada for Maclean’s by driving through small towns, stopping for coffee and talking to people. Denise Wong summarized some of the things he noticed on his trips for CP24 — lots of boarded up businesses; so tightly boarded that it doesn’t look as if they’re ever coming back, and a surprising (to him) lack of grocery stores and banks.

Grocery store, bank, postal office and a gas station — the starter pack for any small town. And yet, these services dry up, leave town if there isn’t enough money there for them to justify operations. Banks have systemically closed brick and mortar operations, pushing people to online banking. This has forced people travel further to access banking services if they can’t do something online (and if you operate a business account or an account for a not-for-profit, you know that sometimes, you have to go into the branch). Canada Post has aggressively gotten out of the business of brick-and-mortar stores, even though people in small towns still need mail and parcel services. It’s all in the name of saving money. Saving money. Cut back and save all of the money you can. It’s just a coincidence that corporate profits hit a record high in Canada’s history in 2022. Don’t think about that too much.

And every time another one of these closes, so too disappears another job, another source of money to fund the operation of the local gas station or grocery story.

5.

Small towns can’t survive neoliberal capitalism. Their existence — their distance from modern shipping routes, the lack of services to attract low-income workers, their small population basins from which to draw workers — pose unmovable barriers to the capitalist machine. There are no solutions to saving a small town that don’t include intentionally resisting neoliberal capitalist logic. And for ideas about how to do that, while we could read Marx, we can also remind ourselves why these towns existed in the first place.

The Canada of 2024 is not much like the Canada of 1904. We are decades past the era where governments engaged in any serious industrial planning. Small towns popped up where new transportation routes were planned. From being a stop on the Grand Trunk Railway to being along the basin of a river, access to hydro power or transporation fueled the industries of small towns across Canada. There was a reason for these towns to exist: industry. And with industry came the need for rooming houses (and then entertainment), services, religious and spiritual community, social organizations, and so on. Even better, industries created spin-off industries.

And governments cared about industrial policy. They created industrial policy that would encourage new factories and new industries to grow out of these small towns. The colonization of Canada was based on the rapid industrialization of Canada — making it a real country — and very little was left purely to chance. The invisible hand of the market makes for a great fairytale. But when you’re trying to prove to the world that your country is real and exists, you need to take concrete actions to ensure that things are real and that they do exist.

But today, the only industrial policy we have is to allow corporations to beat their annual profits earnings by any means necessary. So, rather than a job in a lab or at a bank or whatever attracting someone to live in a place like Smooth Rock Falls, local politicians have resorted to things like tax breaks or bonuses. Tax breaks — cutting into the meagre tax revenue they already have — to convince someone to move somewhere that has very little industry, where you may have to travel to go to the ER. Where’s the quality of life in that?

It gets worse when you consider that the jobs that have stuck around have gotten shittier by several orders of magnitude. No longer can you work your life as a baker in your local Tim Horton’s. No, for decades now, baking happens outside the store, in factories staffed by low-waged workers working in dangerous working conditions for basically no money. They don’t get to see the faces of the people who chomp into their eclair or fritter (do they still even make eclairs?). Neoliberal capitalism didn’t just eliminate jobs in small towns, it also made them so desperately shitty that the only people who are willing to staff them are often leaving their country in the hope of finding a job that pays more than they might make in the Philippines or India or Jamaica. The added bonus is that these folks can’t vote; they can’t manifest their unhappiness. They aren’t even able to stay long-term.

The small town relies on the work of people who are not allowed to retire in the same community they’ve worked in for a decade.

6.

Now, it isn’t as if the small town is uniquely allergic to neoliberal capitalism. Cities suffer too, though in different ways. There, economies of scale also works against cities: there are too many people to move, too much poverty, not enough of anything unless you’re rich. The life and death of Canadian cities is a different, though similar story.

But the small town is the canary in Canada’s second most favourite money-maker. And when a corporation like the CBC, which is also on the ropes thanks to neoliberal capitalism, muses openly that perhaps emergency rooms are just too difficult to keep open in a small town, that maybe all we need is better paramedics and a nursing station or a taxi service to the closest city or whatever, the fix is in. There is no desire in this country to reverse the trends that are destroying the very essence of Canada and journalists are happy to play along, as long as, well, I don’t actually know what is in it for them because sucking up to the machine isn’t going to save their jobs when the axe falls in the end.

Donald Trump has promised a new era of American politics and he has taken aim at Canada. He isn’t breaking with neoliberal logic entirely though. He will usher in a new version of it that doesn’t assume that US hegemony will last forever (because it will barely last the next five years). It will likely be fascist-adjacent or protofascist or perhaps just straight-up classic Mussolini shit. But regardless, Canada needs to prepare itself and all we have on offer is the promise of more neoliberal capitalism.

We can get out of this death spiral but it isn’t going to be easy. And we can’t look to a single politician to save us — they’re all deeply implicated. When imagining the future of a small town, if it doesn’t include real-life services and instead, the land that’s been for sale for a decade is finally bought up for a brand new energy centre to fuel AI (aka the latest fad for instant cash transfers to the already-rich), then we are sunk.

Because if we can’t imagine a functional small town in 2024, how on earth can we imagine a functional city?

p.s.

I grew up in a small town that was somewhere between a proper small town and a bedroom community for white flight. When I moved to Quebec City, I realized just how much of the neighbourhood that I was radicalized into wanting from Sesame Street. I have that today more than I ever have, and this skit is in my head more often than not when I pass by people I know as being people in my neighbourhood.