Alcohol abuse and obesity must be tackled more systematically or they could 'derail' overall health improvements, the health and spending watchdogs have warned.

A joint report, Are We Choosing Health? by the Healthcare Commission and the Audit Commission has assessed the impact of government policy on efforts to improve people's health. It has concluded that public health objectives must be clearer, more ambitious and easily measurable.

It says there must be consistent policies across national government and regionally and locally to address lingering health inequalities across the country and between manual and non-manual workers.

The commissions found the public health programme over the last 10 years has improved life expectancy and reduced the number of people dying through major killers such as circulatory diseases and cancer.

Initiatives to reduce smoking and teenage pregnancy have made inroads and there is better access to sexual health services, the report says. However, these improvements have not been matched in either alcohol misuse or obesity. The report is critical of the fact that there was no national strategy to tackle alcohol misuse until 2004 and even then it did not have clear, measurable objectives or a systematic plan for delivery. For obesity there was no national strategy until this year.

Healthcare Commission chief executive Anna Walker said: "The government should apply lessons learned from its most effective programmes to ensure that the problems of obesity and alcohol misuse do not derail health improvement in the future."