Last week the Des Moines-based Child & Family Policy Center released “Iowa Kids Count 2010: Trends in the Well-Being of Iowa Children.” Highlights from the report are after the jump. While several indicators showed improvement in children’s health between 2000 and 2010, the economic circumstances of Iowa children and families deteriorated significantly.

I was intrigued by an article in today's Des Moines Register about Dr. David Nash, who advocates training “oral health therapists” to handle simple procedures for children's teeth.

My cousins who are dentists probably wouldn't like this idea, but Nash made a compelling case:

Nash, who spoke at a conference in Johnston, framed the problem as an issue of justice and fairness. He criticized fellow dentists for concentrating on profitable treatments, including cosmetic procedures. He said they should spend more time on public-health needs, including care for poor children insured under Medicaid.

Dentists often say they limit their Medicaid work because the program pays them too little. But Nash said states that have dramatically raised reimbursements have not seen corresponding increases in dentists willing to accept more Medicaid patients. “Many dentists just do not want to see these people in their offices,” he said.

[…]

The professor has made waves nationally with a proposal to create a new class of “oral health therapists,” who would receive two years of training in the treatment of children. They could perform typical dental-hygienist duties, plus simple fillings, crowns and extraction of baby teeth. They could be posted in schools, pediatricians' clinics or mobile clinics, he said. Such therapists provide safe, economical treatment in 53 countries, including New Zealand, Britain and Canada, he said.

I have a friend whose family is on Medicaid, and I know she has struggled to find a dentist to fill her daughters' cavities. The family dentists or pediatric dentists recommended by me and other friends do not take Medicaid patients. She wants to avoid getting mercury amalgam fillings, and the only dentists in the Des Moines area she can find who take Medicaid patients use mercury in the fillings.

I'm sure there are arguments to be made against Nash's idea, but it seems to merit serious consideration. 

When I was in college nearly 20 years ago, I remember reading an article in the Des Moines Register about the rising rate of births by cesarian-sections in Iowa. At some rural hospitals, the rate was approaching 25 percent, and that was alarming to some doctors.

Now almost a third of all births in Iowa are by c-section, and in some counties that figure is above 40 percent.

During the past week, the Des Moines Register, Cedar Rapids Gazette and several other newspapers  published this piece from the Associated Press about the rising rate of cesarean births, which quotes several women in Linn County and Johnson County.

Unfortunately, the article does a poor job of assessing the causes of the this trend and ignores the most significant problems associated with unnecessary c-sections. I explain why after the jump.