Challenges
American Indians have the highest rate of poverty and some of the lowest rates for service intervention. As of 2009, impoverished American Indian seniors averaged 21.9% of those between the ages 65 and 74, and 26.3% of those aged 75 and older – nearly twice the average of differing ethnic counterparts. 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 population.  Although the tribal programs and infrastructure for providing the services exist; however, due to limited funds, only base-level services can be provided. The NSAIE reaches approximately 20,000 American Indian seniors living in tribal areas affected by poverty.

Health Disparities
American Indian seniors face some of the worst health disparities. Cardiovascular disease, cancer, diabetes and obesity are among the most concerning and immedate problems facing American Indian seniors. The diabetes epidemic within American Indian populations is so severe, that there are a variety of Indian Health Service initiatives adressing this devastating disease.

American Indians have the highest rates of diabetes and obesity in the world; these conditions often arise because of an inadequate level ofphysical activity and a diet composed of inexpensive, highly processed and  preserved foods. These foods are typically made out of  simple carbohydrates that easily convert to sugar in the blood stream. Because these foods are often much cheaper and easier to access than their nutrient-dense counterparts, they have become a staple on reservations and in tribal communities after years of impoverishment.

Traditional foods that were once the staple of American Indian subsistence are nearly the opposite of the current diet. Traditional foods are high in fiber and minimally processed, consisting of lean game that was once abundant and available to tribal members. Today, traditional foods are poorly represented in today’s senior centers. Menus at the senior centers, which generally consist of a single meal per day, are developed within limited program budgets. Most of the foods that are incorporated into the senior center menus are nontraditional in nature, and often do not make use of nutritional foods like cholla buds, acorns or the wide variety of other locally grown and traditional foods.

Rural America
This group faces the additional hardship of the difficulties of aging in rural America. Lack of transportation, reasonable access to healthcare, and nutrition are exacerbated by geographic isolation. These deficits are illustrated by the following:

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. Furthermore, of those involved in motor vehicle crashes, elders are at a much higher risk due to “decreased safety belt use, poor road conditions, inadequate street illumination, and inadequate or insufficiently accessible emergency medical services, ” all of which are symptoms of remote rural living.

The National Society for American Indian Elderly works to address the problems associated with geographic isolation: high rates of poverty and lack of senior services. Programs on reservations and in tribal communities provide vital nutritional and emotional support to isolated elders. With limited available Federal funding, it is necessary to leverage outside resources. In conjunction with AmeriCorps, the NSAIE is currently providing personnel that help fill positions which in turn increase grant dollars, improve service quality and expand current services to a larger portion of American Indian seniors.