Through a glass darkly: what should public health observatories be observing?

BACKGROUND: Eight regional public health observatories were launched in England in February 2000, to strengthen the availability and use of health information and to support efforts to tackle health inequalities at local level. This qualitative study was carried out by the Merseyside and Cheshire Zone of the North West Public Health Observatory to assess the needs of local users and producers of public health information. METHODS: Semi-structured in-depth interviews were carried out with 42 representatives of three major groups in Merseyside and Cheshire: community groups, public-health-related professionals in the local statutory and academic sectors, and information specialists within the National Health Service. RESULTS: Different groups of users and producers encountered different problems in accessing health information. Community groups had significant problems accessing and interpreting health information and were concerned about tokenism and the failure of professionals to recognize lay knowledge. Professionals experienced difficulties in accessing local information from outside their agency and had concerns over partnerships failing to work together to share information. The health information specialists stressed the danger of providing information without supporting intelligence, the difficulty of keeping track of the many local sources, and the importance of having access to local authority data sources. All three groups relied on their own networks in their search for information, and these should not be overlooked in any dissemination strategy. CONCLUSION: Information requires skilled interpretation to become policy-relevant public health intelligence. This research identified major problems in the communication of lay health knowledge and in the accessibility of public health intelligence.