It can be both. Look at the stress hormones people live with. Look at other stats like rising infant mortality, dropping IQ etc.

> Look at the stress hormones people live with.

https://research.senedd.wales/research-articles/poverty-and-...

Does being poor cause mental health issues, or are mental heath issues a cause of poverty... The answer here clearly better access (read free) to mental heath care, and it wont have the impact one would think (see the UK data).

> Look at other stats like rising infant mortality

You mean the attributions tied directly to maternal complications: https://www.cdc.gov/nchs/data/vsrr/vsrr033.pdf

The thing is we changed how we collect this data, to something that would be considered bad: https://www.washingtonpost.com/health/2024/03/13/maternal-mo... - There are tons of criticism on how we collect this data, they are valid, if you dont like this source, find another its a mess of our own creation.

> dropping IQ etc.

The largest root cause is that people spend too much time on their cell phone dumbing themselves down. Think about that one... no one feels the need to elevate themselves, they are happy to spend time on what amounts to leisure. Would you have sympathy for the person who gets fired cause they chose to play 18 holes of golf 5 days a week rather than do their job?