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Challenges

American Indian seniors have the highest rates of poverty and some of the lowest rates for service intervention. The NSAIE reaches approximately 20,000 American Indian seniors which live in areas with extremely high rates of poverty. In fact, poverty rates for American Indian seniors over the age of 60 years exceed 70% in these tribal areas1.

Health Disparities
American Indian seniors face some of the worst health disparities, with cardiovascular disease, cancer and diabetes exacting a heavy toll on this population2. The diabetes epidemic within American Indian populations is so severe, there have been and are a variety of Indian Health Service initiatives to address this most devastating disease.

American Indians have the highest rate of diabetes in the world, which is often compounded by a diet heavy on inexpensive, highly processed and highly preserved foods made of simple carbohydrates that convert easily into sugar in the blood stream3. This diet has been a staple on reservations and in tribal communities for years. Traditional foods that were once the staple of American Indian diets, however, are nearly the opposite of the current diet. Additionally, these highly processed foods are often much cheaper and easier to access than nutrient dense foods. Many traditional foods are high in fiber, minimally processed, and consist of lean game that was once so available to tribal members. Although these traditional foods are nutrient dense, they are poorly represented in today’s senior centers. Menus of the foods served at the senior centers, which are generally limited to serving a noon meal to its seniors, are developed within the limited budgets provided for these programs. Most of the foods that are incorporated into the senior center menus are non-Indian in nature, and often do not take into account the nutritional value of traditional foods such as cholla buds, acorns or the wide variety of other locally grown foods.

1 Indian Health Service, Trends in Indian Health. Rockville, MD: Author. 1997, cited in John, R. (1999). “Aging Among American Indians: Income Security, Health, and Social Support Networks.” In T. Miles (Ed.), Full-Color Aging (p. 74). Washington, DC: Gerontological Society of America. 2 John, R., & Baldridge, D. (1996). The NICOA report: Health and long-term care for Indian elders. A report by the National Indian Council on Aging for the National Indian Policy Center. Washington, DC: National Indian Policy Center. 3 Administration on Aging, U.S. Department of Health and Human Services, Native Elder Health Care Resource Center, University of Colorado; National Resource Center on Native American Aging, University of North Dakota. (1996, December). Executive Summary. Home and community-based long-term care in American Indian and Alaska Native communities Washington, DC: Author

Rural America
This group faces the additional hardship of the difficulties of aging in rural America. Transportation, reasonable access to healthcare, and nutritional deficiencies are compounded by geographic isolation. These needs can be demonstrated with the following indicators:

• According to the United States Bureau of Indian Affairs, 318,000 American Indians over the age of 55 years live in physically isolated tribal lands as of the year 2000. This number is anticipated to grow to 654,000 by the year 2025.
• According to the National Resource Center on Native American Aging at the University of North Dakota, less than 30% of American Indian elders living on reservations are able to get themselves to a doctors appointment with their own transportation.
• The Administration on Aging (AoA) reports that 32% of all American Indian elderly over the age of 65 live in a one-person household, the majority (82%) of which are frail women who report needing assistance with more than one Activity of Daily Living (ADL).

The combination of geographic isolation, high rates of poverty and limited access to services is the reason that the National Society for American Indian Elderly was created in an effort to address these social problems.

Senior service programs on reservations and in tribal communities provide vital nutritional and emotional support to isolated elders. Unfortunately, the need for elder services outweighs the current resources. In 2003, the Older Americans Act Title VI programs, the main source of funding for American Indian senior programs, served just over 8% of the eligible population4. The tribal programs and infrastructure for providing the services exist, however, due to the limitation of funds, base level services are all that can be provided. A minimal increase in the available funds would allow tribal senior programs to expand services by two to three hundred percent. With limited available Federal funding, it is necessary to leverage outside resources. The NSAIE is currently doing so, in conjunction with AmeriCorps providing personnel that help fill positions that work to increase grant dollars, improve service quality and expand current services to a larger percentage of American Indian seniors.

4 Figures are based on total population of American Indians over the age of 60 and the total number of Title VI services delivered according to the AoA for 2003.

Image: Northwestern University Library, Edward S. Curtis's 'The North American Indian': the Photographic Images, 2001. http://memory.loc.gov/ammem/award98/ienhtml/curthome.html