data used for “Water fluoridation: Health monitoring report for England 2022” on hip fractures

AEHSP made this Freedom of Information request to Department of Health and Social Care

Automatic anti-spam measures are in place for this older request. Please let us know if a further response is expected or if you are having trouble responding.

Waiting for an internal review by Department of Health and Social Care of their handling of this request.

Dear Department of Health and Social Care / Office for Health Improvement and Disparities (OHID),

Under the provisions of the Freedom of Information law we request data that was used to produce a recent report by the Office for Health Improvement and Disparities (OHID) titled “Water fluoridation: Health monitoring report for England 2022”. The report is available at this URL:

https://www.gov.uk/government/publicatio...

We request the data that was used for the analyses of the hip fracture outcome. The section of the report headed “Health outcomes and potential confounders” on pages 24-30, gives details on the data used for the report.

1. We request, for each geographical area MSOA (Middle-layer super output area), the total number of hip fracture emergency admissions, for the time period 2016/2017 through 2020/2021.

2. We also request for each MSOA and the same time period, the number of hip fractures by gender (males and females, separately).

3. We also request for each MSOA and the same time period, the number of hip fractures by these four age categories which were used in the report:

0-49 years
50-64
65-79
≥80

4. We also request for each MSOA and the same time period, the number of hip fractures by gender and by the same four age categories, giving a total of eight sub-categories.

The data could be supplied as four separate files or as a single file with one (or both) MSOA identification fields and eight fields for counts by sex and age group:

MSOA identification code
MSOA identification name
males 0-49 years
males 50-64
males 65-79
males ≥80
females 0-49
females 50-64
females 65-79
females ≥80

The report says the software STATA was used for data management and analyses. We therefore ask that the requested data be supplied as an electronic file in STATA format. Alternatively, we request it be supplied as an Excel file. Here is the report’s description of the software used for producing the report:

"DATA MANAGEMENT: Data cleaning, management, and visualisation were conducted in STATA 16, R 4.1, and R Studio 2021.09.0. Data analysis was conducted in STATA 16."

Yours faithfully,

American Environmental Health Studies Project (AEHSP)

Department of Health and Social Care

1 Attachment

Dear AEHS,

Please find attached the Department of Health and Social Care's response
to your recent FOI request (our ref: FOI-1403760).

Yours sincerely, 

Freedom of Information Team
Department of Health and Social Care

show quoted sections

Dear Department of Health and Social Care,

I am resubmitting my request and including my full name, to meet the condition of section 8(1) of FOI, as you requested.
My name is Mr. Chris Neurath.

Yours faithfully,

Chris Neurath
AEHSP

Dear Department of Health and Social Care,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Department of Health and Social Care's handling of my FOI request 'data used for “Water fluoridation: Health monitoring report for England 2022” on hip fractures'.

On May 2, 2022 I submitted my FOI request. On May 27, 2022 I received a response asking me to submit my full name. I did so on May 27, 2022 and asked that my original request be considered resubmitted. It is now June 26, 2022 and more than 20 days has passed and I have heard nothing. I request an internal review at the Department of Health and Social Care for failure to meet statutory deadlines for response to my request. I would also note that the initial rejection on the grounds that a full name was required was not sent to me until the very last possible day to meet that deadline. It seems unreasonable that such a simple problem with my initial submission could not have been addressed more quickly. If it really took 20 days to realize my request was lacking a full name that suggests that if it had not been lacking a full name the response would have taken longer than 20 days because there would have been no more days to locate the requested data after the screening determination for a full name. In other words, there seems to be evidence the department has intentionally tried to delay a response to my FOI request.

Therefore, I request that the internal review be done as expeditiously as possible, or if the department intends to grant my request that they let me know promptly when they expect to do so.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/d...

Yours faithfully,

Chris Neurath
AEHSP

Department of Health and Social Care

1 Attachment

Dear Mr Neurath,

Please find attached the Department of Health and Social Care's response
to your recent FOI requests (our ref: FOI-1407001 and FOI-1407002).

Yours sincerely, 

Freedom of Information Team
Department of Health and Social Care

show quoted sections

Dear Department of Health and Social Care,

In your response to my FOI request number FOI-1407002 you said:
"FOI-1407002 . I can confirm that the DHSC does not hold the information relevant to your request. The files you have requested contain data provided by NHS Digital. Therefore, you may wish to contact NHS Digital directly with your request. "

I am requesting an internal review because it is not plausible that DHSC does not hold the information that I requested.

Firstly, NHS Digital is a subdivision of DHSC, so if the data were truly held by NHS Digital then it is also held by DHSC as the overarching department. But aside from the semantic mischaracterization by DHSC, a careful reading of the DHSC response quoted above acknowledges that the data files I have requested exist. The quote says "The files you have requested contain data provided by NHS Digital". So, while the files may contain data provided by NHS Digital, that does not mean the data files I requested, which were the data files used for a specific DHSC report, are held by NHS Digital. In fact, according to the report itself, if they are to be located within a specific subdivision of DHSC the most likely one is the "Water Fluoridation Health Monitoring Working Group, comprising colleagues from both OHID and the UK Health Security Agency (UKHSA)." The DHSC report does not name any individual authors, but the Water Fluoridation Health Monitoring Working Group or the individual members of that group are the most likely to hold the data files that were used to prepare the report, or know where they are located.

As part of an internal review of my FOI request, I ask that the requested data files be specifically sought from the Water Fluoridation Health Monitoring Working Group, or anywhere else within the overarching remit of DHSC where they could plausibly be found.

Secondly, it is implausible that DHSC does not hold the requested records, because my FOI request was based on specific data files used to prepare a report published by DHSC in March 2022. My request named the report and included the URL for it and the pages of the report that explain in detail what data was used to produce the report. My request can be boiled down to this one sentence in my original request:
"We request the data that was used for the analyses of the hip fracture outcome."
Surely the data underlying the report must be available to DHSC since a subdivision of DHSC produced the report and the report was published by DHSC. The report could not have been produced without data!!!

My request described in detail the data concerning hip fracture incidence used in the report and even quoted from the report the specific file format and software used to manage the data and used to conduct the statistical analyses that form the basis of the report. While it may well be true that NHS Digital was the source of the "raw data" used in the DHSC report, a major part of the work involved in creating the report was adapting the "raw data" to a form appropriate for the statistical analyses conducted in the report. One example of the adaptation of the raw data was the stratification of hip fracture hospitalization data into specific age and sex categories used in the report, as well as classification by MSOA geographical area. My request specified the exact same age, sex, and MSOA classification groupings as were used in the report. In other words, my request asked for the exact same data files as were used to prepare the report. I did not request "raw data" or data in any form other than the the same form as was used in the data files for the report.

The report does not name any individual authors, but does acknowledge which subdivisions within DHSC prepared and contributed to the preparation of the report:

"Acknowledgements
This report is published by the Office for Health Improvement and Disparities (OHID). It was prepared by the Water Fluoridation Health Monitoring Working Group, comprising colleagues from both OHID and the UK Health Security Agency (UKHSA). This report would not have been possible without UKHSA's invaluable contribution.
The Water Fluoridation Health Monitoring Group would like to thank the following organisations and individuals for their support in preparing this report:
•Drinking Water Inspectorate
•Local authorities
•External peer reviewers"
[DHSC 2022 report, p 4]

Both OHID and UKHSA are subdivisions of DHSC, and therefore the Water Fluoridation Health Monitoring Working Group would come under DHSC for purposes of FOI requests.

If any additional clarification may be required to fulfill my FOI request and internal review, please contact me.

Yours faithfully,

Chris Neurath
AEHSP