It's becoming harder and harder to stay... but also harder and harder to leave. It's not just job/friends/HCPs/etc but also the cost of moving, and the cost of starting somewhere else (security deposit or downpayment on a place to live, being able to afford housing, transportation, and utilities, finding your own community in places where people only interact with each other and get to know each other at their jobs or at their children's school or play events...