Jan. 27 (Bloomberg) -- President George W. Bush will address a nation next week that has soured on the direction of the country and his leadership on issues ranging from health care to the economy to Iraq.

A Bloomberg/Los Angeles Times poll taken this week as Bush prepares to deliver his annual State of the Union speech shows that the president wins the approval of only 43 percent of the public, a 7-point drop from a year ago. Three out of five say America is seriously off course, and by 62 to 31 percent those surveyed want to move in a different direction than the one Bush has set forth.

The president has lost public support across a broad swath of issues, including most of the ones that especially concern Americans, as well as on matters of personal trust and leadership, according to the survey.

"Presidents who lose their credibility, who lose the ability to persuade people that they're leading the country in the right direction, have a tremendous political burden to overcome, and that's where he's at," said Robert Dallek, a retired Boston University professor who has written nine books on presidential and diplomatic history. He said the modest goals Bush is likely to set forth in his speech next week reflect the fact that "he's not any longer at the top of his game. His political capital has been expended."

Edge on Terrorism

The one issue on which Bush maintains an edge over Democrats -- by a 13 percentage-point margin -- is on policies to protect the nation against terrorism. Many of those surveyed think Bush's policies have made America more secure, and most support Bush's view that Congress should reauthorize the USA Patriot Act.

Still, there is a pervasive pessimism, decidedly more than a year ago, among many Americans.

"There's definitely something wrong," said Gina Lucchesi, a 36-year-old office worker from Woodstown, New Jersey and a Republican, who participated in the survey and was interviewed afterwards. Marion McLaughlin, a 78-year-old retired government worker from Hanover, Connecticut, and a Democrat, complained that Bush is "totally off-track" and "out of touch with reality." Both cited health care, economic adversity, and the Iraq war as top concerns.

Among the key findings of the Jan. 22-25 survey of 1,555 Americans, which had a margin of sampling error of plus or minus 3 percentage points:

Priorities

-- Health care is the top domestic issue Americans want the president and Congress to address in the coming year, and the one on which Bush attracts the most criticism. The most pressing other priorities are Iraq, fixing Social Security and combating terrorism.

-- More than half say the situation in Iraq wasn't worth going to war over and don't believe Bush when he says the U.S. military is making a lot of progress there -- although a plurality, 40 percent, say the U.S. should maintain troops in the country for as long as it takes to stabilize it.

-- Most Americans hold Congress in low regard, with three- fifths ranking lawmakers not good or poor on ethics and honesty. Large majorities favor new laws prohibiting lobbyists from holding fundraising events for congressional candidates and barring lawmakers from traveling on corporate jets for the cost of commercial air travel.

A Democratic Edge

-- The Democrats hold an advantage among registered voters for the November elections even though their unfavorable ratings are slightly higher than the Republicans'. Forty-six percent of registered voters say they would like to see a Democratic candidate win in their district, while 37 percent prefer a Republican victory. On all domestic issues -- including taxes, the budget deficit and health care -- at least a plurality say they trust congressional Democrats over Bush.

Much of the erosion of Bush's support comes among women and independents, according to the poll. While 48 percent of men disapprove of Bush, a 5-point increase from last year, his disapproval rating among women increased 10 points and is now 60 percent. Among married women, a group that has historically been a source of strength for Bush, his approval rating dropped 6 points to 43 percent. Among independents it dropped 11 points to 39 percent.

Among Republicans

In the past year Bush's approval rating dropped 6 points among Republicans to 79 percent. Self-described moderate Republicans accounted for the erosion, with Bush's rating dropping from 79 to 65 percent among this group; among self- defined conservative Republicans, Bush's rating stayed constant.

Bush's ratings on personal leadership qualities have long been his strong suit, even when Americans sometimes questioned his policies. The latest poll shows those ratings have eroded somewhat: 50 percent say he is a strong leader and 46 percent that he's honest and trustworthy, a drop of 11 and 10 percentage points respectively since November 2003, when the Times last polled on those questions.

The percentage of Americans who believe the nation is seriously off on the wrong track has increased 13 points from last January.

On the question of terrorism, while a plurality of those surveyed trust Bush over congressional Democrats, the president's approval rating on the issue has dropped off in the past year. Now, 48 percent approve of his handling of the issue and 49 percent disapprove; a year ago 54 percent approved and 43 percent disapproved.

Health Care

Disapproval of how Bush is handling health care has increased 19 points since February of 2003, the poll found. These findings underscore the political significance of Bush's intention to make health care a focal point of his Jan. 31 State of the Union address.

Conrad Greenwood, a 47-year-old farmer from Auburndale, Wisconsin, is a Republican who supports Bush on every issue -- except health care. Greenwood, who was diagnosed with bladder cancer last year, has no health insurance.

"I can't afford it," he said. "If it wasn't for the help of the hospital and some grants, I would have nothing left. They should not let these insurance companies get so rich," and Bush "lets them get away with it," he said. Greenwood supports nationalizing health-care coverage.

Bernard Ginyard, a 50-year-old Democrat who became paralyzed while working at his landscaping job in 2001, said health care is the biggest problem facing him in life.

`Out of Hand'

Ginyard, who lives in Winston-Salem, North Carolina, with his wife, said he receives $900 a month from Social Security and disability benefits but doesn't qualify for Medicaid, the government health program for the poor. "We can't live off that" and pay medical bills, he said. "It's really out of hand."

Along with health care and the economy, Bush gets a high disapproval rating on the Iraq war. He hasn't lost ground on Iraq; his 41 percent approval rating on it, with 56 percent disapproving, is similar to a year ago, when a Times poll found that 42 percent approved and 54 percent disapproved of his handling of the war.

Americans aren't overly pessimistic about the future situation in Iraq, with 34 percent saying it will improve over the next year, 44 percent saying it will stay the same and only 19 percent expecting it to worsen. Yet 58 percent say the conflict either had no effect on Iraq's stability or destabilized the country. More than half of those surveyed, including about one in five Republicans and three in five independents, say the war wasn't worth fighting.

`Still Getting Killed'

"There are people still getting killed over there, and he's not pulling them out," said Robin Priest, a 40-year-old political independent who lives in Portsmouth, New Hampshire, and provides home care to the elderly. "It just doesn't feel right."

The poll did find narrow support, within the margin of error, for Bush's decision after the Sept. 11 attacks to authorize government surveillance of telephone calls and e-mails without court order, which has drawn intense criticism from lawmakers and civil liberties advocates. Forty-nine percent said the surveillance was acceptable, while 45 percent disagreed; 52 percent said Bush shouldn't be impeached over the issue even if a congressional investigation concludes that he broke the law.

More broadly, about half of those surveyed said they wouldn't mind if the government monitored their own phone calls. "It wouldn't even bother me," said Curtis Simmons, a 43-year- old maintenance worker from Rockford, Illinois. "I ain't got nothing to hide."

Lobbyist Rules

In the wake of the ethical scandal triggered by lobbyist Jack Abramoff, the poll found strong support for stricter enforcement of lobbying laws and changes to make them tougher. Abramoff pleaded guilty on Jan. 3 to conspiring to corrupt lawmakers and aides through campaign contributions, overseas trips and entertainment.

More than four-fifths of those surveyed said existing laws either need to be more strictly enforced or made more restrictive, with just 11 percent saying no change is needed.

Barring lobbyists from holding fundraising events for congressional candidates is favored by 65 percent of those surveyed, while 72 percent would prohibit the practice of allowing lawmakers to travel on jets provided by corporations and lobbyists for the cost of flying on a commercial airline.

"The American people, a lot of them, have lost their trust in the government," said Laura Seal, 50, of Sneedville, Tennessee.

Bush and Ethics

Those surveyed have conflicted views on Bush and ethics. Asked how he compared to most modern presidents on ethics and honesty, 39 percent said Bush was similar, 26 percent ranked him higher and 32 percent said lower. When asked whether Bush had restored honesty and integrity to the White House, three-fifths said no.

Although registered voters surveyed give the Republican- controlled Congress low marks on its performance, with 57 percent saying they disapprove of the way it is handling its job, Democrats don't appear to be improving their overall image. Just 35 percent of registered voters have a favorable impression of congressional Democrats, while 41 percent have a favorable impression of Republican lawmakers.

Yet those surveyed trust Democrats more than Bush to manage every major issue -- from the deficit to taxes and health care -- with the exception of terrorism. The 9 percentage-point Democratic edge among registered voters on which party they'd like to win in their congressional district increases to 12 points among all of those surveyed.

Bush's weakening support puts him "in Rodney Dangerfield territory," said Charlie Cook, editor of the Washington-based Cook Political Report, referring to the late "no-respect" comedian.

"Members of Congress don't feel obligated to support you on anything and people in the other party don't feel afraid to buck you," said Cook. "That's just when your own party starts running against you."

To contact the reporter on this story:
Heidi Przybyla in Boston at  hprzybyla@bloomberg.net.

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