Much of the lyrical content of The Suburbs is inspired by band members Win and William Butler's upbringing in the suburbs of Houston. However, this song is about multi-instrumentalist Régine Chassagne's hometown of Montreal. Win Butler told The Sun: "It's interesting that there are similarities between Houston and the south shore of Montreal, where Regine grew up. A song like Sprawl 2 is about Montreal. Over the bridge it's the same as the Houston in 'City With No Children.'"
The UK music publication NME asked Win Butler what track on the album he is most proud of lyrically. He replied: "I guess it'd be either 'The Suburbs' or 'Sprawl 2 (Mountains Beyond Mountains) because in each of those tracks there's kind of a whole world. There's more going on in the margins of those songs, and I think if you really get into the lyrics, there's a lot of new stuff to find."
This song was named after Tracy Kidder's 2003 biography of Paul Farmer, the Boston anthropologist and doctor who co-founded Partners in Health. The NGO is integral to the efforts to rebuild co-vocalist Régine Chassagne's home country of Haiti after the 2010 earthquake that destroyed the already impoverished Caribbean nation.