Researchers have long noted the disproportionate disease and mortality burden borne by residents of rural areas of the U.S., as well as disproportionate economic opportunities to develop wealth. Moreover, researchers have highlighted rural youth migration citing factors that push residents away from the communities in which they were raised. The project team will identify and summarize the literature on the rural youth exodus, the disproportionate burden of disease, and variations in opportunities for wealth for rural Americans. Our findings will provide the Federal Office of Rural Health Policy with a comprehensive scoping review they can utilize for policy development and advocacy.