The culture of places are not so well defined in America. It is a new nation of immigrants. Europeans may have lived in the same towns for hundreds or thousands of years. American is less than 250 years old.
Americans identify as individuals. An individual is identified by personal accomplishments or work. Alternatively, a group identity might define a person by location or family name. The root question "who are you?" is asked depending on what approach you take. Identity is a subjective social construct; neither approach is more right than the other.
Most of us would be able to get perfectly good jobs in our own home towns, earning a modest living near where we grew up via the trades, real estate, teaching, selling insurance, etc.
We chose to pursue more because the opportunities are there and we want them. That's because of how much we value ourselves and the extraordinary opportunities that we have in our lives. It has nothing to do with how we value others.
I'm very successful and I'm thankful for the opportunities that have put me where I am. I enjoy my work and I'm thankful for that. I also had a stretch where I worked really hard and alienated myself.
But that is a problem that I also chose to fix.
I made an effort to get to know my neighbors, to invite them to lunch, to join a local church, to get involved in a local rotary club, to meet local small business owners. There's a surprisingly large amount of people who are more than happy to grab a bite for lunch and as you get to know people better, you invite them to other things when you discover you share interests. Making friends in a new area takes a little bit of work, but it's more than worth the time.
I'm shocked we have Medicare to be honest. Though, it's been highly debated for quite some time, so we only barely have it, and many would prefer we didn't have it. (at least, until they themselves get old...)