Two independent watchdogs are today calling for a renewed drive to improve public health services after analysing the success of policies over the past decade.
A new report by the Healthcare Commission and Audit Commission assesses the impact government policy has had on narrowing health inequalities, improving sexual and mental health, and reducing smoking, alcohol misuse and obesity.
It finds the government's ambitious public health programme has helped significantly improve overall life expectancy and reduce mortality from the big killers.
There have also been advances in tackling smoking and improving sexual health, two areas where health inequalities are significant.
Teenage conceptions are at their lowest level in over 20 years and there is better access to genitourinary medicine services and chlamydia screening, although progress in relation to contraceptive services has proved challenging.
But these rates of improvement have not been matched in the areas of alcohol misuse and obesity.
In England, which has the fastest rising rate of childhood obesity in Western Europe, a third of school age children are overweight or obese.
If the trends continue, alcohol and obesity will have an increasingly profound effect on public health and service delivery, the report says. The steep rise in the number of people who are overweight and obese or suffering from alcohol-related illness could reduce the impact on mortality rates of recent improvements in heart disease and cancer, plus increase rates of diabetes and hypertension.
The report comments that a 2004 national strategy to tackle alcohol was not accompanied by clear measurable objectives or a systematic programme to drive change through the system. As a result, improvement at a local level has been inconsistent. Similarly, there was no national strategy to tackle obesity across the whole population until 2008. This programme must remain a priority as it will require sustained effort and resources to deliver.
Steve Bundred, the Audit Commission's Chief Executive, said: "We owe it to our children to look at the lessons of the past 10 years to help us focus on the challenges facing public health issues over the next 10 years."