Sheldon J. Segal is no longer with us. Segal, 83, died October 17 at his home in Woods Hole, MA. Although his work helped millions of women all over the world, he labored and died in relative anonymity.

What gives?

Segal is credited with leading the team that developed the contraceptive implant Norplant. He was also instrumental in the development of the Mirena intrauterine device and copper-bearing IUDs. In other words, Segal played a critical role in what the Centers for Disease Control and Prevention calls one of the greatest public health achievements of the past 100 years---contraception.

You might have missed this news because the front page of several major newspapers featured other such absolutely essential fare as the fight for airplane overhead space (USA Today) and a new opus from Stephen King (Wall Street Journal).

What gives?

Rest in peace, Sheldon Segal, and thank you.

Women currently account for 51% of the overall U.S. population, according to the U.S. Census Bureau. To be precise, there were 154,135,120 women and 149,924,604 men in the United States in 2008. We also know that women, more often than not, are responsible for making decisions about their families' health care.

While I think it would be hard to make the leap that 51 percent of the programs and benefits of health reform should be directly targeted toward women, it's not a stretch to argue that health reform should address the health care needs of women and their families. That includes pregnancy planning and prevention.

Unplanned pregnancies are closely linked to a number of negative health, social, and economic consequences. Family planning services--counseling, gynecological care and screenings, prescription drugs and devices, and related outpatient services--are a cost-effective way to make progress on preventing unplanned pregnancy and improving health outcomes for women and families. As such, family planning should be classified as a preventive benefit with the same cost-sharing protections afforded to other designated preventive benefits in any essential benefit package that is created within the context of health reform.

For health reform to work, it has to be meaningful for everyone, including 51 percent of the U.S. population.

Why is it that some people are better listeners than others? You can tell when someone is listening to you--really listening--when they're actually taking in what you're saying, considering it, and perhaps not even having a response at the ready--not simply planning their next conversational move. Listening is a form of respect, and one that is easily mowed over by the desire to get one's own point across. Like a monologue masquerading as a dialogue.

Since October is "Let's Talk" month (see Bill Albert's post from earlier this month), maybe the added attention will get some parents to move from wanting to talk with their teens about love, sex and relationships to actually doing it. But a critical part of this conversation--and really any conversation with someone you care about--has to be the listening part. We've heard from teens for over a decade now that they are afraid to ask their parents about sex and contraception because they are convinced that mom or dad will freak out and assume that their teen is already 'doing it.' Or that it will be so embarrassing their heads will explode.

Watching the video above I am reminded of the challenge we face in the world of reproductive health—a world I am still getting to know—of trying to make adherence fun.  The piano stairs do a fabulous job of enticing people to walk and work off a few extra calories.  Fun can change behavior for the better.

The challenge for us is that contraception is not so fun.  Even the names of contraception methods—an opportunity for fun—are usually horrible.

Perhaps we can take some cues from toothpaste. Bill Smith, in his recent Social Marketing Quarterly article "The Power of the Product P, or Why Toothpaste Is So Important to Behavior Change," says that what we need to affect change is a product like toothpaste, not ideas. "An idea, like 'health is good,' 'exercise works,' or even 'environmentalism' is the affirmation of a belief, not a social marketing product," Smith wrote. And only a product can be effectively marketed. "Toothpaste," he went on to write, "is a product that helps us achieve our marketing goal of behavior change (bushing teeth)."

We don't try to get people to brush their teeth without toothpaste, but we do ask them to take HIV tests and obtain birth control without compensating them for the stigma they experience. "All we have to do is invent products and services that are as good as toothpaste, update them regularly to keep people interested, price them competitively, put them everywhere, and then tell people how cool they are," Smith challenged. Are we up for the challenge?

Where's the toothpaste?

If it's Tuesday, it must be Belgium. If it's October, it must be "Let's Talk" month.

This is the time of year when parents are poked and prodded to pontificate about sex. Specifically, October is the month that parents are--steady on friends--encouraged to talk to their kids about sex. Don't get me wrong, encouraging often-recalcitrant parents to talk to their kids about sex is the right thing to do. Still, it has always struck me as a classic case of putting the cart before the proverbial horse.

Why? My sense is that not a single parent in America will talk to their kids about sex if they believe that what they have to say will fall on deaf ears; if what they have to say will have absolutely no effect on their beloved offspring's decisions about sex.