The Texas Department of Transportation recently reported that the amount of litter along Texas highways continues to decrease – down 37 percent since 2009 – saving countless millions in taxpayer dollars who foot the bill for the cleanup. What, you might ask, does this have to do with health care?  Plenty if we pay attention.

The “Don’t Mess With Texas” campaign launched January 1, 1986, as a 29-second Cotton Bowl Public Service Announcement (PSA) developed on a shoestring budget featuring the legendary blues guitarist Stevie Ray Vaughn. It was targeted at 18-35 year-olds responsible for the majority of litter in Texas. The plan was simple and direct: make the PSA with Texas musicians playing “The Eyes of Texas,” have them look up and say in their best serious voice: “Don’t Mess with Texas,” then pan back to show a huge Texas state flag. The results were astounding, immediate, and measurable with huge drops in Texas highway litter being noted within a year – and continuing to this day.

What if we, the health care community, did something similar? Today, our nation faces the public health equivalent of the Four Horsemen of the Apocalypse: obesity, hypertension, diabetes and tobacco. These factors are driving us toward unavoidable doom, their horrific ravages amplified ten-fold by our nation’s health care illiteracy.

But what if took a relatively paltry sum and put it towards a campaign to influence the health care behavior of our 18-35 year olds just like Stevie Ray Vaughn did for litter? Perhaps begin with a contest, a la “American Idol,” for the best PSA in each musical genre, targeting our highest risk groups, the prize for each: a million dollars and a contract. Then, around each PSA and tag line, develop a 10-year implementation plan and stick with it, saturating the media frequented by this demographic with the PSAs.

Oh, I know that many, perhaps most, will think the idea foolish, expensive and unlikely to work. Many think that of Health Information Technology for Economic and Clinical Health (HITECH) as well. However, if compared with the health care dollars we will most-definitely be (and already are) spending to treat the inevitable results of these uncorrected risk factors, this idea, if done well, would not only cost less, but would also reduce our future health expenditures, engage our younger demographic more completely and I would argue it would have a much greater societal benefit.

What are your thoughts?

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