By Jaymie Baxley 

No matter where you went in North Carolina in the early months of 1947, the song “It’s All Up To You” was inescapable. 

A recording of the song by Frank Sinatra and Dinah Shore played in heavy rotation on the state’s radio stations and jukeboxes. The swinging big band tune’s lyrics appeared on the front pages of local newspapers. Copies of the song’s sheet music were distributed to public schools, where students were required to learn and perform it. 

Though largely forgotten today, “It’s All Up To You” was written to raise awareness of North Carolina’s poor health conditions at the time. It was the centerpiece of a public education and public relations campaign that had a lasting effect on the state’s health care infrastructure. 

Creating the Good Health Plan

Two years before the song’s release, the State Hospital and Medical Care Commission presented some troubling statistics to the General Assembly. 

North Carolina had had the nation’s highest rate of draft rejections during World War II. More than half of the state’s conscripted men were deemed medically unfit for military service, with many of them suffering from hookworm, tuberculosis and other diseases. 

By 1945, North Carolina had only 2,300 doctors for its 3.5 million residents. The shortage of physicians was so severe that a quarter of babies born in rural counties were delivered without a doctor present.

Thirty-nine of the state’s 100 counties lacked hospital beds for Black patients, who in the Jim Crow South were forced to seek care at segregated facilities. In 33 counties, there were no hospitals at all. 

These and other issues contributed to the abysmal state of conscripts’ health. 

At Gov. Joseph Broughton’s request, members of the commission developed a plan to improve the situation. Their proposal called for the construction of hospitals and clinics to provide “better distribution of facilities, medical care, and public health services for every citizen Irrespective of race, creed, or financial resources.”

They called it the “Good Health Plan.”  

Calling on Kyser 

The commission knew it needed public support to persuade lawmakers to fund the $48 million plan.

In March 1946, the commission organized a meeting of 200 of the state’s “leading medical men and laymen” in Thomasville. From that gathering came the Good Health Association, a volunteer committee that sought to “educat[e] the people of North Carolina as to the desperate need” for more doctors and hospital beds. Isaac Greer, superintendent of the Baptist Children’s Homes orphanage, was named the association’s president.

Hoping to enlist a well-known North Carolinian to assist with the effort, Greer reached out to bandleader Kay Kyser. The Rocky Mount native had released several chart-topping swing records with his big band orchestra in the 1940s. He had also appeared in a string of successful Hollywood comedies, including “You’ll Find Out,” “Playmates” and “My Favorite Spy.”

Ol’ Professor of Swing Kyser needed little convincing. After learning about his home state’s health woes, the musician embarked on an impromptu tour of more than 30 counties to solicit funding for the education campaign. He also drew from his experience in show business to craft a marketing and publicity prospectus for the Good Health Association, which adopted the document.    

Over the next few months, marketing from the campaign was unavoidable. The association used dramatic billboards, brochures, news releases, displays in pharmacy windows, essay writing contests for school children and all manner of other media to extoll the benefits of the Good Health Plan.

But Kyser believed that many residents “would never read about the State’s bad health record, or listen to even the most eloquent speaker discuss startling statistics,” according to a report released by the association at the campaign’s conclusion.

“He felt that these people would, however, sit up and listen to a musical appeal.”

Spreading the ‘health alarm’

Kyser passed the assignment to arguably the second most successful songwriting duo, behind Rodgers and Hammerstein, on Tin Pan Alley. 

Lyricist Sammy Cahn and composer Jule Styne were established hitmakers in New York, having first teamed up three years earlier for the Oscar-nominated “I’ve Heard That Song Before.” Their most enduring collaboration, the Christmas staple “Let it Snow! Let it Snow! Let it Snow!,” propelled crooner Vaughn Monroe to the top of the charts in 1945.

Cahn and Styne wrote the words and jaunty music for “It’s All Up To You” in less than 24 hours. They framed it as a call to action, urging North Carolinians to “spread the health alarm to every town and farm” across the state.

“We need vitamins and medicines and beds to spare

Places where the sick can go and get some care

Lots of new equipment to combat disease

Clinics where the poor can go for moderate fees”

The lyrics also reference Leonora Martin’s poem “The Old North State,” which would be recognized a decade later by the General Assembly as the official toast of North Carolina: 

“If we do these things then we will be the state 

Where the weak grow strong and the strong grow great”

With the association’s “musical appeal” now on paper, Kyser set out to find singers who could make “It’s All Up To You” resonate with radio listeners. As luck would have it, he shared a record label with two of the country’s biggest rising stars.

Sinatra and Shore 

Frank Sinatra and Dinah Shore were among Columbia Records’ most popular acts in 1946.

Sinatra had released his first full-length album, the best-selling “The Voice of Frank Sinatra,” earlier that year. Though he was a New Jersey native, Sinatra had something in common with many men in North Carolina: He had also been rejected for military service during WWII. 

Shore, a new signee to Columbia, was enjoying a successful run of singles that included “Laughing on the Outside (Crying on the Inside)” and “The Gypsy,” which peaked at No. 2 on the Billboard chart.

When Kyser approached Sinatra and Shore with “It’s All Up To You,” they agreed to sing it for free. They recorded their vocals with Kyser’s orchestra in about an hour at a studio in Connecticut, according to newspaper reports. 

“It’s All Up To You” officially premiered in North Carolina on New Year’s Day in 1947 as part of a special program broadcast on every radio station in the state. More than 9,000 copies of the track were later sent to the stations to give out to listeners.

“Even after they had given away their allotment of the records, many radio stations continued to play ‘It’s All Up To You’ daily, and disk jockeys reported many requests for the number,” read a report published by the association. 

Records were also sent to the superintendents of county and city school systems, along with printouts of the song’s sheet music. Some schools required students to perform “It’s All Up To You” during Good Health Week that February. 

The track was provided to jukebox operators in the state’s largest cities. Displays promoting the song were placed in the windows of record stores. Stories about it ran in newspapers. 

One article, published in The State Port Pilot of Southport, called the recording a “songsation.”

“Perhaps no single phase or feature of the never-a-dull-moment Good Health publicity campaign has clicked so decisively as this latest device,” the paper wrote.  

Lasting impact

The Good Health Plan was approved that March by the legislature, which agreed to put $32 million — equivalent to roughly $440 million in 2023 — toward the initiative. 

An additional $16 million came from the Hill-Burton Act, a federal measure signed into law the previous year by President Harry Truman to increase the nation’s supply of hospital beds. 

Money from the act would eventually fund the creation of 230 health care facilities in North Carolina, according to the National Health Law Program. 

In addition to its role in expanding the state’s hospital system, the Good Health Plan paid for the construction of a four-year medical school at the University of North Carolina in Chapel Hill. 

The once-ubiquitous anthem that helped drum up support for the plan has faded into obscurity, but it hasn’t been lost to time. “It’s All Up To You” can be heard today on Spotify, Apple Music and YouTube.

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