This chapter examines the complexities surrounding exacerbated health disparities and their impact on rural youth mental health outcomes amid a global pandemic. Indisputably, a host of health, economic, and social challenges are associated with the unprecedented interruption caused by the global pandemic. In the same vein, several challenges and concerns about the overall academic and personal/ social experiences and outcomes of school-aged children have resulted in societal concerns about the overall preparation of this generation to meet the leadership and employment demands of a global society. While the COVID-19 pandemic highlighted chronic issues related to health disparities to include intergenerational health, environmental and socioeconomic disparities, and educational inequities, many of these issues have had a longstanding, disproportionate effect on African American (AA) youth and their families. This is particularly the case with AA youth who live in rural communities, that are largely characterized by persistent poverty along the margins of society. Food and housing insecurities, social isolation, and lack of access to adequate physical and mental health resources are a few of the issues faced by these youth and other individuals who belong to these often tight-knit, rural communities. These issues, along with scarce or no availability of medical and mental health care services reflect larger systemic issues which speak to cultural determinism and social justice.