IT'S an emotive subject. Getting people off incapacity benefit and back to work is one of Tony Blair's top priorties.

But for many people living in areas like Blaenau Gwent - which has the second highest level of long-term sickness in Wales - improving a community's health means the government must first solve the problem of poverty.

There are 2.7 million people on incapacity benefits in the UK and the government plans to remove any incentives for people to remain within the welfare system.

Proposed changes to incapacity benefit prompted rebellion from 65 Labour MPs in 1999, but Mr Blair still sees a strong case for reform.

Last week the prime minister unveiled a major overhaul of the system and said: "Those who play by the rules will get the help, those who don't play by the rules should start doing so."

More than one in five members of Blaenau Gwent's potential workforce - 22.1 per cent - claim incapacity benefits for sickness or disability.

In Wales only Merthyr Tydfil has a higher percentage of people out of work because of health reasons, with 22.6 per cent 'on the sick'.

Yet neighbouring county Monmouthshire has the healthiest workforce in the country with just 7.5 per cent too sick to work.

Also published this week was Health Status Wales, a detailed report of the nation's health, by chief medical officer Dr Ruth Hall.

It revealed that people's assessment of their own health varied around the country but 12.5 per cent in Wales reporting their health as "not good".

In Blaenau Gwent that figure was 16.5 per cent, again the second highest in Wales behind Merthyr Tydfil.

The report also showed that life expectancy in Blaenau Gwent is lower than the Welsh average for both men and women.

Dr Hall said the overall health picture for Wales is getting better but admitted the improvement wasn't happening fast enough.

She said: "We've underestimated the size of the task in front of us in improving health."

Blaenau Gwent MP Llew Smith was not surprised by the figures.

He said: "For a long period we've been near the top of the lists on illnesses, which range from heart and respiratory diseases to lung cancers.

"It's part of our industrial past in coal and steel. There's a clear link between deprivation and health issues.

"It's nothing to do with a culture of benefits. We can't tackle our industrial past but we can tackle deprivation."

Peter Law, Blaenau Gwent's Assembly Member, agrees. He said: "The poverty here goes back 25 years to the first steel closure.

"Since then we've lost thousands of well-paid jobs which have never been replaced.

"With a lack of wealth comes poor quality of life and that leads to poor health.

"The government needs to target deprivation and work to provide full employment here to fight the inequalities in health."

When asked to define deprivation in his area, Mr Law points to the fact that Blaenau Gwent has one cinema for 60,000 people and hardly any independent restaurants.

"Why should new businesses come here when they know nobody has any money to spend?" he asks.

"Less than a mile away from where I'm talking right now is Powys, where the life expectancy is two or three years longer than it is in Blaenau Gwent."

Mr Law said those who contributed to Britain's economy in the coal mines and steelworks are now paying the price with a range of chronic illnesses.

"The legacy we carry from our great industrial past is long-term sickness."