Table 3. Quotes explaining the challenges to turning data into information for public health practice according to local health departments.

Staff Position, LHD	Quote
Communicable disease supervisor, Suburban LHD	“I feel like there's a lot of data that comes in, but there's not a lot of data that goes back out into the community…Why are we collecting all this data if we're not informing people of what we're finding?”
Vital records staff, Suburban LHD	“The [LHD director] wants the information for statistics and sharing with city planning to see where risk areas may be…The state does have canned reports that we can request, but he wants more specific and that we cannot get it from the state or we can’t generate it ourselves without individually going through each birth certificate and pulling out the information we need.”
Epidemiologist, Urban LHD	“For the most part, the state reports, they don’t always have the data that we need at the local level. And since we can’t run reports at the local level, we do have to go back to the state to request the information.”
Epidemiologist, Urban LHD	“…People at the state have found that sometimes their own data release policy is too restrictive and there’s definitely people who work there that do realize that there is some value in releasing some aggregate data so any of the stakeholders who are interested in it could learn something from it.”
Communicable disease supervisor, Suburban LHD	“I don't know how to run reports well enough for STD yet to be able to feel comfortable pulling the data and using it for strategic planning. I would rely on our old manual paper because I know that is accurate.”
Nurse supervisor, Suburban LHD	“I’m so busy dealing with the day-to-day activities that it’s like, ‘Okay you need this report, fine I give it to you whatever,’ but truly right now I’m just kinda like overwhelmed ...”
Communicable disease staff, Rural LHD	I've heard them talk about making reports...but I really don't have the need for it right now.”
Immunization program director, Urban LHD	“The biggest challenge we have is the overall integration of the data systems. So it's not just immunizations, it's STD and communicable disease and everything that they're doing, there's health information in there, but I don't think there's anybody that really knows how to pull that information out and utilize it effectively. We have such a patchwork that there's no way, without an incredible amount labor and resource, to sort of pull those things together.”