The last store for someone

When the only pharmacy or grocery in a small town closes, the loss seems out of proportion to the business. The store may have been barely profitable. Its sales, set against a chain's quarterly report, were nothing. Yet the town talks about it for years, as if something structural had gone.

The usual explanation is geography: the last store of its kind is worth more than its sales because every trip it served now becomes a drive to the next town. That is part of it. But the evidence points somewhere more precise. A store is singular not to a place but to a person, the customer who cannot use the alternative, and a closure does not cut a town's access evenly. It splits the town.

Who follows the goods

In 2020 one of the three grocery stores in Martin County, Kentucky, a rural Appalachian county of about 11,000 people, closed suddenly.¹ Researchers who had already been surveying residents' shopping and diet followed them up a year later.¹ Those who had switched from a local grocery to a supercenter reported eating more fruit and vegetables than before.¹

The study is small, 74 people completed the follow-up, and the year in question was the first year of the pandemic, so it proves little on its own.¹ But it breaks the simple picture. For a household with a car, a closure can be an inconvenience that leads to a bigger store with more choice.

Chains reason the same way. When Walmart closed a batch of stores in 2016, it said that 95 percent of them were within 10 miles of another Walmart.² For a customer who drives, that is a substitute. For one who does not, 10 miles is a different town.

Who does not

The other half of the split shows up in the pharmacy data. A national study of prescription claims among adults 50 and older, covering 2011 to 2016, compared people whose pharmacy closed with similar people whose pharmacy stayed open. After a closure, adherence to statins fell by about 5.9 percentage points on average, and the gap persisted for a year. Beta-blockers and anticoagulants fell by similar amounts.³

The drop was larger for patients in neighbourhoods with fewer pharmacies, about 8.0 points, and for patients of independent pharmacies, about 7.9.³ But it happened everywhere, including where another pharmacy was available. Claims data cannot say why. The likeliest reading is that the pharmacy that closed was not only a counter but the place where that patient's prescriptions, refill dates and routine lived, and moving all of that is work some patients never get round to. Mail-order and delivery can replace the pills; they do not obviously replace the person at the counter who notices a refill is late.

Then there is what a store carries besides goods. Researchers at Penn State interviewed long-term residents of a rural Pennsylvania township that had lost its only grocery store along with other everyday places. Residents described the store as a gathering place whose closure disrupted daily routines and casual social contact. Some had no way to get to the next store; one said a dozen people they knew personally had no way to reach a grocery. The dollar store that later opened sold little fresh food.⁴

The floor, not the average

Put together, the closure of a singular store is a sorting event. People with cars and flexible routines follow the goods, sometimes to something better. People without transport, and people whose lives were organized around that particular counter, fall out. In the Pennsylvania township, it was older residents and those without reliable transportation who found the next store hardest to reach.⁴

That is also why the store's revenue undersells it. Revenue measures what the average customer pays. The store's value to the town was concentrated in its least mobile customers, for whom it was not one option among several but the only one: a floor of access, not a share of a market. Neither its owner nor the chain that closes it is paid for that floor, so it can close for sound business reasons while the loss lands on people who were never part of the decision.