Towns rely on volunteer Emergency Medical Services who provide ambulance service to the nearest hospital, which may be as far as 70 miles. Several Towns have local health centers. The Town of Long Lake advertised and hired an MD who agreed to settle in the community. He specializes in Family Practice. Other communities are served by the Hudson Headwaters Health system, who staff the local health centers on a rotating, part-time basis.
Several communities have their own elementary schools, then bus the children to high school.
There are over 350 lakes and ponds in Hamilton County and hundreds of miles of rivers and streams. The growing season is very short, and there are years when there is frost every month. Snowfall is on average over 100 inches per year. Hamilton County is the only county located entirely within the Adironack Park. There are many miles of hiking and cross country ski trails and 750 miles of snowmobile trails.