It’s a bright spot in a fairly dismal data landscape for communities with above-average shares of African-American residents: Three Atlanta-area counties, and one near Augusta, Georgia, have better outcomes in a U.S. News assessment of the drivers of health and well-being than most other areas with significant black populations.

Yet in Georgia, that beacon of hope is hard for some to see: While black residents in Cobb, Columbia, Fayette and Paulding counties may be thriving, plenty of people in the Atlanta area and around the country are still struggling, says Nancy Flake Johnson, president and CEO of the Urban League of Greater Atlanta.

“Things are absolutely not where they should be and there is a desperate need for balance and recalibration,” Johnson says.

While housing measures can be strong determinants of health outcomes – the four Georgia counties perform particularly well in a measurement of housing capacity, according to the U.S. News Healthiest Communities analysis – Johnson notes that health disparities between African-Americans and whites actually begin with more basic factors such as income and education.

“Research has also consistently demonstrated a strong link between housing and health,” she says. But the poor, she says, tend to be undereducated and stuck in low-wage jobs.

That means living in a quality home – or neighborhood – can be a distant goal at best.

“Compound (race-based income disparities) with the fact that the current administration has dismantled the Affordable Care Act and the state of Georgia has repeatedly refused to expand Medicaid coverage to low-income families,” and it’s not surprising the health of many Georgia residents is suffering, Johnson says. “Without adequate income to cover medical costs, many low-income, rural and working Georgia families’ health access and care is negatively impacted.”

Johnson recently spoke about housing and other drivers of health during a recent interview with U.S. News. Her remarks have been edited for length and clarity.

It seems that transplants – high-income African-Americans who moved to Atlanta as adults – are driving positive health outcomes. But homegrown residents born or raised in Cobb and Paulding counties say it’s still tough for them. What’s your analysis?

Read more at U.S. News and World Report