Taking off the blinders: why community health planning needs peripheral vision
In October of 2024, I was standing in the middle of the lodge of our local summer camp, surrounded by a flurry of community partners placing sticky notes on their top health priorities. I watched with my co-facilitator as yellow, green, and red post-it notes filled up sheets representing the five priorities that had already been narrowed down by the group. While we strategized about how to facilitate the upcoming conversation—knowing that all issues are important but not all can be priorities—and anticipated the chaos to come, I felt something else brewing in the room. There was an undeniable energy, a gravitational force pulling together various (and sometimes competing) desires into one mission, one vision for the community.
Community planning can sometimes feel entropic—everything seems to be going in different directions. But maybe that doesn't mean things are falling apart. Maybe it means something powerful is taking shape.
Traditional public health planning often operates with the mindset that complex community problems can be solved through linear processes: identify the issue, gather data, develop interventions, implement programs, measure outcomes. This mechanistic approach treats communities like machines where pulling the right lever produces predictable results. But communities aren't machines. They're living, breathing ecosystems where small actions can ripple into massive changes and where the most carefully crafted plans can dissolve in the rapidly shifting undercurrent of federal funding priorities, human and organizational capacities, and community concerns.
In our rapidly changing landscape, the question isn't whether we will allow chaos, but whether we will learn to dance with it.
Control means tunnel vision
The illusion of control acts like blinders on a horse—it creates tunnel vision that blocks out crucial peripheral information. We become so focused on staying in our lane that we miss the opportunities and threats approaching from the sides.
While working in local public health, I assisted with an initiative to bring a harm reduction vending machine to our community. The machine would host naloxone nasal spray alongside fentanyl testing supplies, safer sex kits, and hygiene supplies. It met a community need we had identified through data collection, and we had secured support from various local partners, including one that would host the machine at their agency. But in the time that passed from grant application to funding receipt, the landscape changed—and suddenly we didn't have a host. Soon we would have a machine arriving on a truck with nowhere to put it.
The solution to this breakdown in community planning wasn't better control—it was our partnerships. We leaned into other relationships we'd built and eventually reached an agreement for a new location. This seems like a simple fix, but it required serious legwork from health department staff and, crucially, an ability to work with the chaos rather than against it.
This scenario plays out repeatedly in community health work. Planners invest enormous energy trying to predict and control variables that are fundamentally unpredictable. We create detailed project timelines assuming perfect coordination among dozens of independent organizations. We design programs based on static community assessments that become outdated before implementation begins.
I had to learn that the harder we grip the reins of control, the more likely we are to be thrown when the unexpected occurs. Yet the alternative isn't to abandon planning altogether—it's to reimagine what effective planning looks like in complex systems.
From boardroom to dance floor
I'm a first-born, Type A Capricorn—a planner by any measure. In my first formal facilitation, I learned quickly that community planning must happen organically or risk becoming static. I had to abandon my need for control and my desire to know exactly what would happen next in order to move the process (and the people) forward toward completing a Community Health Improvement Plan.
My approach ultimately meant maintaining a present but flexible structure that kept us on track while remaining open to possibility—whether that meant new partners joining us or community-level events that stirred up our development process.
The core of this structure was agreement on shared values through developing a mission and vision for the health coalition. We presented a charter that provided structure for completing the health improvement plan by clarifying roles and expectations. This approach created a strong but responsive foundation that could hold up the party—a diverse group of community partners—while remaining adaptive to changing circumstances.
Don't hold your community meetings like you're in a boardroom. Hold them like you're on a dance floor. Keep an eye out for natural pairings and partnerships, and don't hesitate to help your partners fill out their dance cards through introductions to new collaborators.
Some tips for the dance floor:
Collaborate to define shared values and vision that guide the work. Like a good song that everyone knows, shared purpose gives people something to move to together, even when individual steps vary.
Provide a setlist for the DJ, but be open to requests from the dancers. Structure matters, but rigidity kills the energy. Have a plan and be ready to pivot when the room calls for something different.
Keep the invite open. You never know when new people may join the party, bringing fresh energy and unexpected connections that transform what's possible.
The art of peripheral vision
Taking off the blinders means developing peripheral vision—the ability to see beyond our immediate focus without losing sight of our goals. In community health work, this translates to creating planning processes that can hold multiple perspectives simultaneously, recognize emerging patterns before they become crises, and identify opportunities that wouldn't be visible from a narrow, task-focused view.
This peripheral vision shows us that the apparent chaos of multi-partner collaboration isn't disorder to be controlled but information to be processed. Those side conversations during breaks? They're often where the real breakthroughs happen. The agenda item that keeps getting revisited? It might be signaling an unaddressed concern that could derail everything if ignored. The new community concern that doesn't fit your current framework? It could be the early indicator of where your work needs to evolve.
Effective community health planning requires what might seem like a contradiction: simultaneous structure and flexibility. This isn't about abandoning frameworks and hoping for the best. Instead, it's about creating containers that can hold complexity without crushing creativity.
Consider how jazz musicians work together. They have structure—key signatures, chord progressions, agreed-upon standards—but within that structure, there's infinite room for improvisation. The best community health collaboratives operate similarly. They establish clear principles, communication rhythms, and decision-making processes, then trust their partners to improvise creatively within those boundaries.
Build bridges, not barriers
Perhaps the most crucial skill in community health planning is learning to build bridges between competing priorities and perspectives. Every multi-partner initiative involves organizations with different missions, funding sources, timelines, and definitions of success. The temptation is either to force alignment through detailed agreements or avoid difficult conversations altogether.
Neither approach serves the community well. Forced alignment often creates surface-level consensus that crumbles under pressure, while avoiding difficult conversations leaves fundamental tensions unaddressed until they explode at the worst possible moment.
A more effective approach involves creating structured opportunities for partners to explore and negotiate their differences productively. This might mean facilitated sessions where organizations explicitly discuss their non-negotiable priorities alongside areas where they're willing to be flexible. It could include joint site visits where partners experience community conditions together rather than relying on secondhand reports. Sometimes it means starting with small, concrete collaborations that build trust before tackling larger systemic challenges.
The goal isn't to eliminate disagreement—healthy conflict often signals that important issues are being addressed rather than avoided. The goal is to channel disagreement into productive dialogue that strengthens collaborative relationships.
Dancing with purpose
Back in that summer camp lodge, watching those sticky notes accumulate on priority sheets, I realized something profound was happening. What looked like chaos from one angle was actually a community finding its collective voice. The energy I felt wasn't disorder—it was emergence. It was the gravitational force of shared purpose pulling individual priorities into alignment.
The path forward doesn't require abandoning structure or accountability. Instead, it involves developing more sophisticated understanding of when to hold tight and when to let go, when to plan carefully and when to improvise boldly, when to maintain focus and when to follow unexpected connections.
It means recognizing that the messy, non-linear, sometimes frustrating process of genuine community collaboration isn't a bug in the system—it's a feature. It's how communities actually solve complex problems when given the space and support to do so.
For public health professionals, this represents both a challenge and an opportunity. The challenge lies in developing new competencies in facilitation, systems thinking, and adaptive management. The opportunity lies in discovering what becomes possible when we stop trying to impose external solutions on communities and start supporting communities in discovering their own.
The choice isn't between order and chaos. It's between tunnel vision and peripheral vision, between rigid plans that break under pressure and adaptive approaches that bend without breaking, between controlling the process and choreographing it.
In communities, the most transformative health initiatives aren't those that followed the most carefully controlled plans. They're the ones that learned to take off the blinders, develop peripheral vision, and dance with the creative potential that emerges when diverse partners work together toward shared purpose.
The chaos isn't something to be conquered. It's something to be partnered with in service of healthier, more resilient communities. Sometimes the best thing a planner can do is learn to dance.
