The game was not inspired by Centralia PA. Masahiro Ito, the game's art director, has stated this several times. To include someone on Twitter arguing with him that he was wrong.

Keiichiro Toyama explained in an interview, that the game was just a fictional town; in the game, it's snowing; it has nothing to do with Ash or a real town, or anything like that. The name of the town, Silent Hill, is a real town name in Japan.

The movie was based on the town, but the game had nothing to do with it, that was all the movie's director, producer and screenwriter Christophe Ganz who drew that inspiration.