You go to just about any town that small anywhere in the US and you'll see very few with banks or hospitals. They just aren't economically viable, especially if there are banks and hospitals in larger towns nearby. It isn't just an infrastructure issue, it's a matter of market size.

I've lived in small towns for a good percentage of my life. I spent 9 years in Toney, Alabama. I spent almost 2 years in Genoa, Nebraska and 3 more years in Livingston, Alabama. When I lived there, Toney was very small and didn't have much more than a grocery store and a gas station. Genoa had a population of just under 1,000 people when I was there. It had a couple gas stations, a couple restaurants, a very small grocery store and a school that served K-12. It didn't have a hospital. Livingston, population about 3,000, had a hospital when I moved there but it closed a year or so afterwards. For medical care and most other things, people drove 35 miles to Meridan, Mississippi or 55 miles to Tuskaloosa.

When you live in really small towns like Hyder, you go in knowing that many of the things available in larger towns won't be available there. You have to hope that the joys of small town living offset the inconviences, or you'll end up unhappy. My wife and I are strongly considering retiring to a small town somewhere, but we know that the availability of medical care will be a major issue.

Small towns are struggling to survive across America. The kids grow up and end up having to leave because there are few jobs. In the end, the towns struggle to keep their schools open. It's sad to see a way of life dying, but some towns are trying to attract new people. For example, I saw a news segment recently of one small Kansas town that was giving away free land to families who moved there and built a house. The program was working, but in the end, they'll still have to do more to create jobs or those kids will end up moving away. The new people were stimulating economic activity, both in construction and in retail. New businesses were springing up all over town.