President Obama is confronting declining support for his handling of the war in Afghanistan and an electorate confused and anxious about a health care overhaul as he prepares for pivotal battles over both issues, according to the latest New York Times/CBS News poll.

But Mr. Obama is going into the fall having retained considerable political strength. At 56 percent, his approval rating is down from earlier in the year but still reasonably strong at this point compared with recent presidents.

More Americans are starting to credit his stimulus package with having helped to revive the economy. And Mr. Obama retains a decided advantage with the American public over Republicans on prominent issues, starting with health care.

The poll found that an intense campaign by Mr. Obama to rally support behind his health care plan — including an address to Congress, a run of television interviews and rallies across the country — appears to have done little to allay concerns.

Majorities of respondents said that they were confused about the health care argument and that Mr. Obama had not done a good job in explaining what he was trying to accomplish.

“The Obama administration seems to have a plan, but I’m not understanding the exact details,” Paul Corkery, 59, a Democrat from Somerset, N.J., said in a follow-up interview.

But the poll suggests that Mr. Obama is in a decidedly more commanding position than Republicans on this issue as Congressional negotiations move into final stages. Most Americans trust Mr. Obama more than Republicans to make the right decisions on the issue; 76 percent said Republicans had not even laid out a clear health care plan.

And by a lopsided margin, respondents said that Mr. Obama and not Republicans had made an effort to cross party lines and strike a deal that has the support of both parties. Two-thirds of respondents said they wanted Congress to come up with a bill supported by both sides.

At the same time, there has been a slip in confidence in Mr. Obama’s handling of the war in Afghanistan. There is tepid support for maintaining troop strength there, much less increasing it, as his top commander in Afghanistan prepares to submit a request for additional forces. A majority of Americans do not want troops there for more than two years.

Taken together, the poll reflects the crosscurrents buffeting the president on every major issue. Americans still trust Mr. Obama and seem willing to follow him, particularly in contrast to Republicans. But he is not quite the commanding figure he was in the spring, and his policies do not enjoy the support they once did.

At 56 percent, Mr. Obama’s job approval rating is similar to what President Ronald Reagan’s was at this point in his first term (53 percent); President Bill Clinton’s was at 43 percent. Still, Mr. Obama’s approval is down from 68 percent in the spring.

The percentage of people who approve of the way he has dealt with Afghanistan has dropped to 44 percent from 56 percent in April. The percentage of Americans who approve of his handling of the economy, at 50 percent, has dropped from 61 percent since April. In April, Mr. Obama had a 43-point advantage over Republicans in terms of who would make the right decisions on the economy; that has dropped to a 26-point advantage.

Americans think the economy is on the mend, and there has been a 15-point increase, to 36 percent, in the percentage of Americans who said Mr. Obama’s stimulus package has improved the economy.

The poll of 1,042 adults was conducted by telephone from Saturday through Wednesday. It has a margin of sampling error of plus or minus three percentage points.

There is evidence of public distaste with Washington that washes across both parties. Nearly two-thirds of respondents said they believed that Republicans in Congress were opposing Mr. Obama’s bill only for political gain; just over half said Democrats in Congress backed the bill for political reasons.

Just 30 percent said they had a favorable view of Republicans in Congress. By contrast, 47 percent said they had a favorable view of Congressional Democrats.

“What I hear from the Republicans is that they’re just against anything the president has to say,” said Matt Lee, 48, a Republican from Kona, Hawaii. “There is just too much division along party lines right now. I don’t think the president wants to hear anything the Republicans want to say, but I trust him more because we need change.”

Mr. Obama was not spared from this sense of jadedness; 56 percent of respondents said they did not expect Mr. Obama to be able to keep his promise not to raise taxes on households making less than $250,000.

The poll reflects the challenges facing the White House as it is consumed by two issues, Afghanistan and health care. By a margin of 52 percent to 27 percent, Americans said Mr. Obama has better ideas about overhauling health care than Republicans. And the percentage of Americans who approve of how Mr. Obama has handled health care has gone from 40 percent in August to 47 percent, about equal to where it was earlier in the summer.

On one of the most contentious issues in the health care debate — whether to establish a government-run health insurance plan as an alternative to private insurers — nearly two-thirds of the country continues to favor the proposal, which is backed by Mr. Obama but has drawn intense fire from most Republicans and some moderate Democrats.

The poll suggested that Mr. Obama’s effort to deal with concerns about the health plan has enjoyed, at best, mixed success. In the poll, 55 percent said Mr. Obama had not clearly explained his plans for changing the health care system, and 59 percent said they thought the health care changes under consideration in Congress were confusing.

The fact that so many Americans say they do not know enough about the plan to offer an opinion — 46 percent — shows the risk of the White House’s strategy of not putting forward its own specific bill.

And there is abundant evidence that critics of the bill made progress over the summer while the White House stayed largely silent: about one in four respondents said they believed that health care legislation would create organizations to decide when to stop providing medical care to the elderly — so-called death panels — despite an all-out effort by Mr. Obama to debunk the claim, which is false. Three in 10 say the bill would use taxpayer money to provide health care benefits to illegal immigrants.

In fact, Mr. Obama has specifically rejected any effort to have the bill cover health insurance for illegal immigrants.

On Afghanistan, more than 50 percent said the war was going somewhat or very badly.

Copyright 2009 The New York Times Company