Not long ago, I accompanied a group of teenagers from one of the most deprived areas of South Yorkshire on a day out. A local charity had invited the youngsters to go orienteering and rock climbing. It was a lovely, sunny day, and most of the dozen or so kids threw themselves into the activities. But there was one boy, Daniel, who didn't seem to fit in.
Daniel was pale and obese, and arrived clutching an inhaler in one hand. He wasn't sure whether he could cope with outdoor pursuits, because of his weak ankles and a badly bruised foot. He said that he lived with his disabled mother, who had run him over on her mobility scooter during a trip to Tesco.
No one seemed particularly surprised by Daniel's health-related misfortunes. He lived in a once prosperous pit village that had floundered since the mines closed. As joblessness had become endemic in the area, so had ill health. A fifth of its working-age population was on incapacity benefit - four times the proportion that was unemployed. An older generation that had inherited trades and work ethics from its own parents had been left with little to pass on but health defects.
The links between poverty and sickness are well documented. Children from the poorest families are twice as likely to die before the age of 15 as those from the wealthiest, and are two and a half times as likely to have chronic health problems. Less well documented, however, is an alarming trend in the number of young people on disability benefits. The statistics are stark. While the overall number of those on disability benefits has dropped by 2 per cent since 2003, the number of claimants under the age of 25 has risen by two-thirds, from 80,000 to 134,000. A similar pattern has appeared across Europe - in the Netherlands, Spain and Switzerland, as well as in eastern Europe and Scandinavia.
Why is this? Surely Labour's attempts to alleviate poverty should have led to corresponding improvements in health? Although the government's pledge to halve child poverty by 2010 will not be met, approximately 600,000 children have been lifted out of poverty. And health statistics tend to show the nation generally, and children in particular, getting healthier. Yet the number of young people claiming sickness benefits continues to rise.
The deprivation map
My initial attempts to make sense of this conundrum led to confusion and even denial. Lurking in the background of every conversation seemed to be the feeling that even to talk about the issue could amount to an admission that claimants were lazy, feckless or dishonest. My approaches to organisations that dealt with young people's rights elicited little response, or simply a refusal to recognise that such a phenomenon even existed. "Government policy is to put pressure on claimants to come off of sickness and disability benefits," wrote one welfare rights worker. Another added: "We are, of course, in the midst of a recession, so the numbers claiming all benefits would be likely to increase."
This last correspondent did seem to have a point. The numbers of young people on Disability Living Allowance (DLA), which is for those with long-term care needs or poor mobility, had been increasing steadily and had doubled since 2003. But the pattern among those on incapacity benefit, for those unable to work, was different. It had dropped for several years, but began to rise rapidly in the autumn of 2008 - just when the recession hit.
So, was the increase in the numbers on sickness benefits in some way related to youth unemployment? Could benefits advisers even have been encouraged to push claimants towards incapacity benefit or its recent replacement, the Employment and Support Allowance (ESA), to keep them off the unemployment statistics?
I visited Lancashire. Its welfare rights service was rightly proud of its efforts to ensure that those entitled to benefits got them. One problem, they said, was that both the poorest and the wealthiest were reluctant to claim. In Chorley, a pretty town with only slightly more than its fair share of discount shops and mobility-aid stores, I met Joe Wilson, a welfare rights worker with a quarter of a century's experience under his belt. "That's a depressing thought," he remarked, as he ushered me into a tiny, windowless room.
Wilson, who was about to hold a benefits advice session, thought there were several possible reasons for the rise in young people on sickness benefits. A major factor, he said, was that Jobcentre Plus staff were offloading applicants to other departments by sending clients to get sick notes and apply for ESAs. "If you're working at the Jobcentre and you're overrun, there's an incentive to get them on to the ESA because then their file is off your desk," he explained. Most are judged fit at their medical, but continue to receive the benefit while they wait months for an appeal hearing. Eventually, they go back to claiming Jobseekers' Allowance.
Yet such mechanistic explanations didn't explain why the numbers of young claimants were rising so much faster than the numbers of older claimants. Even though unemployment had risen fastest among the young, the number on these benefits had risen faster still.
Sitting in on Wilson's advice session, I began to sense the complexity of the issue and the deeper social change that was contributing to it. First up was Mary, who had moderate learning difficulties, worked in a supported job in a factory and claimed a low level of DLA. She had been in special schools and in care as a child. She had no family and struggled with daily life.
Then came Colin, who sometimes felt anxious, and occasionally had a bad back. He had been on incapacity benefit, but it had been stopped. He was appealing. "My doctor has no problem giving me sick notes, but the benefits people don't seem to believe me," he explained. "I don't think I was in the medical more than ten minutes."
Neither Mary nor Colin was incapable of work. "Colin would have worked in a warehouse, moving stuff around. Or in construction," said Wilson. "When there used to be a manufacturing sector, there were low-grade labouring jobs for people with mild learning difficulties. You needed someone to sweep the factory floor. Those jobs don't exist any more."
A picture was beginning to emerge that made sense. Were young people with mild disabilities becoming stuck because the labour market just didn't have a place for them any more? Growing up in areas where traditional industries had died, did they find the route into incapacity benefits clearer than the route into work?
Jim Dickson, head of Lancashire's welfare rights service, agreed that something of the sort was probably happening and that it certainly related to levels of poverty in the area. "If you took the deprivation map of Lancashire and put it alongside a map of DLA claimants, you'd be looking at a mirror image," he told me. "In the old days, the disabilities were work-related. Joiners had arthritis, nurses had bad backs. I don't think that's so strong now."
Instead, there were the conditions of the jobless - depression and anxiety. The proportion of sickness-benefit claimants with mental health problems had been growing, particularly among the young. And there were other modern-day conditions too - ADHD, Asperger syndrome, asthma - all found predominantly among the young and often among the poor.
After my visit to Lancashire, I spoke to Frank Field, the MP for Birkenhead and a former minister for welfare reform. Field, a leading proponent of the view that benefits should help people into work, argued that within Britain's poorer communities, it was not only sickness that was being passed down through the generations. Communities were also passing on their knowledge of the benefits system. "We are healthier as a nation, so there can't be a terrible, plague-like epidemic among those on benefits. There's something else going on," Field said. "There are different groups of young people. Some of them are struggling. Others have no intention of working, but the system accommodates them."
The rising levels of sickness benefit among the young required attention from the government: "These figures are very challenging, and the government has to look at them seriously," Field continued. "It isn't in a young person's interests to be on incapacity benefit - it affects their life chances."
I wondered what would become of Daniel, who was growing up in one of Britain's poorest areas with the odds stacked against him. He had almost every risk factor - he did not have any qualifications, he had been dependent on benefits from an early age and he already had health problems. When I met him, he was about to embark on a course for vulnerable youngsters at his local college. But after that, what next? Would an employer be willing to give him the support and encouragement he so obviously needs? Or would he end up, like his mother before him, with little to look forward to but a life on disability benefits?
Some names have been changed.
Fran Abrams is a journalist and author.