What specific pathologies characteristic of the materially prosperous first world? People almost universally behave better in a functional system with enough housing food education and so forth. Morality is and will always remain important but systems matter a LOT. For instance we've experienced less murder since we stopped mass lead poisoning our entire population.

It's a paradox. We know for an absolute fact that changing the underlying system matters massively but we must continue to acknowledge the individual choice because the system of consequences and as importantly the system of shame keeps those who wouldn't act morally in check. So we punish the person who was probably lead poisoned the same as any other despite knowing that we are partially at fault for the system that lead to their misbehavior.