Why I'm wary of "move" as a solution to problems in remote communities

I guess this is a thing now? There’s a crisis on a First Nation reserve, and a columnist says people living there should move.
At the beginning of this year, following a shooting in La Loche, Saskatchewan, Scott Gilmore took a look at the problems in the village and wrote “the hard truth about remote communities” is:

“isolated communities like La Loche, Sask., will always be far more disadvantaged compared to larger cities in the south; and therefore the best thing we can do for struggling families is to help them move if they want.”

And now, following a spate of attempted suicides in Attawapiskat, Jon Kay has weighed in, arguing “moving is the only real hope”

“In most communities that have no jobs, people pack up and relocate. Whole regions of Atlantic Canada have fallen prey to this cycle of creative destruction. So has much of Detroit. While this process is sad and disruptive, it pushes families to areas where they can make a living and exist in dignity. But the Indian Act created a system that perversely discourages residents from leaving even the most appallingly impoverished reserves — without actually giving them any of the capitalist tools (such as the right to own private property) necessary to prosper.”

A couple things before we get going here:

I am not an expert in poverty, health outcomes, or anything, really

I have not been to La Loche or Attawapiskat, and only know as much about them as you can glean from the variety of articles, tweets, and blog posts out there

So, for all I know Gilmore and Kay and the others echoing their sentiments could be absolutely right and there is no hope for these northern communities.
But I am wary of this idea because I’ve heard similar solutions for problems facing the city I live in.
At roughly 80,000 people, Prince George British Columbia is not as small as most reserves. Nor is it as remote as many of them- it has an airport, two highways, a railway, and serves as a central hub for the region.
And yet by living here I am exposing myself to less opportunities and higher risks than if I moved to a bigger city.
One example: there is no trauma centre here. In fact, there’s no trauma centre in the entire region- if you are in a major accident you have to be airlifted to Vancouver. According to a 2002 study, this makes me six times more likely to die following a survivable accident than if I lived in the Lower Mainland. I am also two-and-half times more likely to die in a car accident.
Going off of data from Stats Canada, I am more likely to be obese, have high blood pressure, and die from avoidable causes that the average Canadian, and the outcomes are worse when compared to the nearest major city, Vancouver. I am also less likely to have graduated from high school or attend university, and will likely die younger. Average incomes here are lower than further south.
At various points in my city’s history, people have seen these problems and fought to change them. To counter lower incomes and education, they rallied to build a university. Disturbed by worse health outcomes and a lack of access to doctors, they created a northern medical program. In response to the toll of having to travel for cancer treatment, a clinic was finally opened here in 2012.
None of these things were easy to do. Perhaps the most infamous example was during the drive to create a university when the advanced education minister told the Globe and Mail there was no need for such an institution up north because “In the interior…people don’t think of education beyond grade twelve. The questions they ask at the end of the day are ‘How many trees did you cut today?’ or ‘How were things down in the mine?’”
And that attitude persists. Almost any time an article about the city gets provincial or national attention (usually for a problem, because that’s the sort of thing that gets national coverage for small communities) someone shows up in the comments section calling it a dirty, stinky, crime-ridden place that no one in their right mind would want to live in. The unspoken question: if you have problems with life there, why not just move?
I’ve been asked this, myself. Not because I’m complaining about problems, but, weirdly, as a sort of compliment. I seem ambitious, capable- why don’t I have aspirations of working in Vancouver or Toronto?
The answer I usually give is a true one: my family is here, I like my job, the cost of living is lower. But there’s a deeper connection, and one that I don’t usually try to articulate.
For whatever reason, I feel like I belong here. And that goes beyond my usual answers. I think even if my parents moved away and I lost my job, I’d stick it out. I’ve lived in other places and came back, not because I had an amazing employment opportunity, but because I felt like whatever life I had, it was supposed to be here. I got an amazing employment opportunity soon afterwards, but it wasn’t even one I knew existed when I made that decision. I came back and made my plans based on how much money I would be able to make working in the service industry on minimum wage. The plan was to be here, and everything else grew around that.
My dad’s a paramedic. He told me a story about when there was an issue with ambulance response times in the north vs. the Lower Mainland, a disparity that still persists. The proposed solution from one of his Vancouver counterparts was that if people in northern B.C. cared so much, they should move south. Now, it’s true: if your primary value is getting the fastest ambulance response time, then maybe you should live in Vancouver. But if you value the community you live in, “move” isn’t really a viable solution to whatever problems your community faces.
I don’t know that I, personally, could handle the harshness of what’s happening on some reserves. But I understand why, for those who do stay, “move” might not be an option. Setting aside the context of colonization and reserves and the fact that outcomes for First Nations people off reserve are often much worse than non-First Nations so moving isn’t exactly a magic bullet– putting all that aside, there are values beyond what, on paper, is best for you as an individual.
I’m not saying people should be forced to stay where they are, and I hold nothing against those who leave, for any reason. And I’m not saying that people living in more rural and remote areas should expect all the advantages and services available in cities- there are certain trade-offs that you should expect. But I disagree with the premise that either you live in a city with an NHL team or you accept worse outcomes for you and your loved ones, and any time you raise the issue you’re told to leave if things are so bad. I disagree with the premise that we should give up on any place that isn’t a major urban centre. I could well be wrong, but I suspect we can do better than “move.”