A 20-question diagnostic for leaders of community health initiatives and public health agencies, built on the 5 principles of the supersetting approach.
Most community health initiatives run activities in many settings. Very few coordinate those activities so they reinforce each other. That coordination, and the synergy it produces, is what Paul Bloch and colleagues at the Steno Diabetes Center named the supersetting approach in 2014. It has since shaped community health work in more than 50 cities on 5 continents.
Supersettings matter because chronic disease is not produced in any single setting, and it cannot be prevented in one either. A clinic, a school, a workplace, and a congregation can each run a good program and still leave a community no healthier, because what one setting builds another quietly undoes. The supersetting approach is the discipline of making those settings pull in the same direction, and in my experience it is the difference between a portfolio of projects and a community that changes.
That experience is personal. In 2014 I founded the Houston program of Cities Changing Diabetes, now Cities for Better Health, as the third city in what became a global network. Paul Bloch's thinking was the intellectual spine of how we built it, and our collaboration over the years since has shaped how I apply it, from Houston's coalition and co-creation model to its adaptation for houses of worship, which made Houston the first city in the network to engage congregations as a strategic health channel. From 2018 to 2022 I replicated the model in Philadelphia, which taught me which parts of the approach travel and which parts must be rebuilt from local context every time. After more than a decade of this work, I kept meeting leaders who sensed their initiative was less than the sum of its parts but had no way to see where the synergy was leaking. I built this diagnostic to give them that view in 6 minutes.
The evidence base keeps growing. In Tingbjerg, a disadvantaged Copenhagen neighborhood where the approach has guided a long-term initiative since 2015, type 2 diabetes incidence declined after 2015 while rising in Denmark as a whole (Olesen et al., BMJ Open 2026). The study design cannot prove the interventions caused the decline, but it is the first documented reduction of its kind in a non-prescriptive community-based initiative.
This diagnostic asks 20 questions, 4 for each of the 5 supersetting principles. It takes about 6 minutes. Answer for one specific initiative, not your organization as a whole.
Your answers stay in your browser. Nothing is stored or sent anywhere unless you choose to share your results at the end.
These shape how your results are interpreted. No answers are stored or sent anywhere.
Scores run from 0 to 16 per principle. Established means the principle is working as designed. Developing means it is present but inconsistent. Emerging means it is largely absent and likely limiting your results.
Klaus Madsen has applied the supersetting approach in community health work since 2015, including building the Houston model now referenced across the Cities for Better Health network. If you would like an informal conversation about your profile, you can send him your results. This is optional, costs nothing, and commits you to nothing. Sending shares your scores, your intake answers, and any notes you wrote.
Email my results to Klaus Copy my resultsIf the email button does not open your mail program, use Copy and paste the results into a message to Klaus at madsenhealth.com.