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Local efforts toward addressing health disparities in DeKalb County, GeorgiaBackground: In underserved African American communities throughout DeKalb County, the DeKalb County Board of Health (DCBOH) is implementing community-based initiatives using policy, systems, and environmental improvement approaches to reduce racial and ethnic health disparities by increasing opportunities for nutrition and physical activity. Methods: The initiatives are being implemented in priority census tracts where the population is at least 40% African American, 30% live below federal poverty level, and 25% did not graduate from high school. Communications promote awareness of the programs, and evaluation activities document processes and outcomes. Results: To date, implementation of five interventions has affected approximately 276,000 DeKalb residents. Conclusions: By implementing strategies for community-based policy, systems, and environmental improvement, DCBOH is increasing access to nutrition and physical activity opportunities for underserved African American communities in DeKalb County.