New targets to spur on efforts to tackle the nation's worst public health problems may not work, experts have warned.
The Department of Health this week unveiled another mixed picture of Britain's health, showing the UK has the highest levels of obesity in Europe.
The second annual health profile of England also showed increases in diabetes and a marked rise in deaths from alcohol-related conditions, such as liver disease and cirrhosis.
The good news is the number of deaths from cancer, circulatory diseases and suicide are falling and average life expectancy is up.
However, the profile revealed there are still huge health inequalities across the country and a continuing North-South divide.
As part of the comprehensive spending review, the government unveiled new public service agreement targets to boost health, with a new focus on childhood obesity and alcohol problems.
However, public health experts told HSJ these may not help reverse the worrying trends shown by the latest figures.
Dr Tim Crayford, president of the Association of Directors of Public Health, said the PSAs and performance indicators were 'tackling the most pressing health priorities'.
But he added: 'There has to be a question as to whether these targets in themselves are enough to drive change or whether, on issues such as childhood obesity, the underlying factors in society that are driving this will overcome the targets.'
He said many health inequalities were linked to poverty. 'Arguably the Treasury has a greater role in driving health inequalities than the health service does,' he said.
Dr Alan Maryon-Davis, president of the Faculty of Public Health, said: 'The fact we have got new figures and new targets does focus primary care organisations and local authorities on areas they really need to push hard on.
'But in a way it's not helpful to keep shifting PSA targets. Policies are here for a relatively short time and so are managers and these things are generational and can take 20-30 years to come to fruition.'
Dr Maryon-Davis said it was vital to join up sources of funding for public health.
'To some extent this can happen through local area agreements but we need to make sure that does happen. We have got to get the funding to work harder for us,' he said.