The trouble with public health annual reports is that no-one reads them. Will putting it on video get round the problem? Claire Laurent reports

Health - The Real Deal won't be available from a video store near you, but that doesn't mean you shouldn't put it on your list of 'recent releases' to watch. Launched by Enfield and Haringey health authority, which reckons it is the first public health annual report to be published in video format, it focuses squarely on inequalities.

The video looks at children attending school in the borough's most deprived area and in its least deprived area and compares life expectancy expectations, use of health services, smoking, teenage pregnancy, mental ill-health, suicide rates, circulatory disease, obesity and levels of dental health. As you would expect, inequalities of wealth equal very clear inequalities of health in all those areas (see box).

The video demonstrates how issues are being tackled and includes members of the public, school children and local community leaders as well as public health minister Yvette Cooper, flagging up the importance of 'working with the local community and asking people what will make the biggest difference to their lives'.

Deputy director of public health Paul Brotherton says the video was designed to capture imagination and generate discussion.

'The annual report is read by individuals or not read at all. The video is visually more appealing and we can use it in groups to generate discussion. '

It has been distributed to local authorities and to schools, libraries, voluntary organisations and GPs. Two thousand have been produced at the not inconsiderable cost of£25,000.

'The cost is higher than the printed version [would be], but what we are trying to assess is the impact of it. Is it cost effective because it's reaching more people and it's generating more debate?'

Reverend Dr Kwaku Frimpong-Manson, chair of Broadwater Farm Residents' Association appears on the video. He says it was welcomed by people because it involved them and demonstrated a knowledge of the issues that effect them. Seeing local community workers on the video improves the message'.

But Dr Alison Hill, director of Oxford HA's public health resource unit, has some reservations about the use of a video for a public health annual report. 'Having been a director of public health, I'm aware that you have to be very clear who your target audience is and you need different methods for different audiences. It's really crucial, if you are trying to inform policy and planning, that you use the right vehicle. '

Dr Hill has just presented to the Department of Health the findings of a three-month survey of the role of the director of public health's annual report. The DoH is likely to consult further with key organisations before producing guidance some time next year.

Reports need to be available in a variety of different forms, she said. 'Not only paper-based but web-based, so it's easy to obtain. '

Dr Hill says the study confirmed the findings of previous reviews of annual reports which showed that their independence was an important factor. It was important, too, for them to be seen as a mechanism of accountability rather than performance management.

Oxfordshire HA director of public health and policy Professor Sian Griffiths says she understands the need to capture the public's imagination. But she warns: 'I think an annual report is more serious than that. I'm quite clear the purpose of the annual report is to report on the health of the population and key issues. It has to monitor progress on things you said the previous year. '

Mr Brotherton points out that all the usual data on Enfield and Haringey's health had been collated and was available on request. The video carries statistics on health inequalities and is accompanied by a booklet. Although it is only available in English, community groups can arrange with the HA for interpreters to be present at a showing of the video to aid discussion.

Professor Mark Baker, medical director and director of public health for North Yorkshire HA, has also made health inequalities the theme of his annual report. He welcomes the Enfield and Haringey approach, saying it is 'worthy of evaluation. '

'The problem with public health annual reports is that nobody reads them. A video could more easily be used in schools and for groups of adults. It's more easily presented to members of the public and can reach a wider audience than the usual glossy document. '

He believes that although a video might cost up to five times that of a printed annual report it might have greater impact. 'If we are serious about addressing these issues through community action, we are simply going to have to spend more. '

Health - The Real Deal. From Elizabeth Henry 020 8272 5575 The rich and the poor Enfield and Haringey has five PCGs: each has been ranked from A (most deprived) to E (least deprived) according to socio-economic indicators. Life expectancy at birth for a baby boy is more than nine years less in social class V than in social class I. Suicide rates in Enfield (least deprived area) was a third less than the national rate, while in Haringey (ranked in the middle of the scale) the suicide rate was a third higher than the national rate. In the most affluent wards, one per cent of girls became pregnant by the age of 18 and five per cent in the most deprived wards.