Larry Curley

Executive Director, National Indian Council On Aging (NICOA) 

The growth of the U.S. came at a tragic cost: the land of American Indians was seized, and their tribes were annihilated. 

Today, American Indians and Alaska Natives have faced repeated attempts to annihilate our history, customs, ceremonies and language. To annihilate us.

Most recently, this threat was COVID-19, which impacted diverse older Americans more than any other demographic. And American Indians, especially elders, felt it keenly. 

The National Indian Health Board has maintained a site that has kept data on the prevalence of COVID-19 in tribal communities in the United States. According to their data, as of this spring, more than 5,981 tribal members had succumbed to the virus. This includes tribal elders like Marshall McKay, 68, chairman of the Yocha Dehe Wintun Nation, and former chairman of the Standing Rock Sioux Tribe Jesse “Jay” Taken Alive, 65.

Of the nearly 6,000 deaths in tribal communities, it is estimated that 60 percent of those deaths were elders over the age of 65. These individuals are holders of great ancestral knowledge. With their deaths, our community has lost an estimated 233,285 years of tribal history, culture and traditions. Some of this knowledge is lost forever.

If only the virus was the sole threat facing our elders.

Healthcare in general on reservations is shaky at best. American Indian and Alaska Native (AI/AN) communities lack adequate health care services and health coverage: A December 2013 report from the CDC states that 27 percent of AI/AN are uninsured almost double the rate of other groups. Other recent studies on Alzheimer’s Disease and Related Dementias (ADRD) in Indian Country suggest that one in three AI/AN will be diagnosed with ADRD in the next few years, compared to one in five among the non-Indian population.

Our elders also have significant healthcare needs, but healthcare facilities on reservations do not have the capabilities for adequate treatment. Elders must then be driven or airlifted to off-reservation hospitals for treatment that is long overdue. Too often, they die there alone, without family and friends to comfort them.

Healthcare infrastructure on reservations by culturally trained healthcare professionals would go a long way in ensuring our elders receive needed treatment without having to travel too far from home.

Home isn’t always a sanctuary, though. Approximately one-third of people residing on Indian reservations do not have running water in their homes, and one-third do not have access to electricity in their homes. Poverty is skyrocketing in our communities, as high as 50-to-70 percent in some areas.

In the 21st Century, this is unconscionable.

We are asking for support to build up the lives our elders are worthy of today. We need infrastructure. We need running water and electricity so our elders can age in place like their white counterparts do in other parts of the country. We need broadband so grandparents can talk to their grandchildren and teach them our languages no matter where they are. Language is infrastructure for human connections, and traditional infrastructure makes those connections possible.

Infrastructure talks in Washington have alluded to $400 billion in support of eldercare and services. The Diverse Elders Coalition, of which NICOA is a member, seeks a percentage of that funding to support the needs of diverse older adult communities across the U.S. NICOA seeks just $50 million to support American Indian and Alaskan Native elders.

This funding would be transformative for programs like Title VII-B of the Older Americans Act ( to establish elder protection programs at the tribal level, Senior Community Service Employment Program (SCSEP’s Set-Aside Program) to provide job training to elder AI/ANs to gain skills for the contemporary workforce, the National Minority and Special Populations Organizations that have the cultural competency and experience necessary to reach our communities, and many more.

The numbers are small relative to multi-trillion-dollar country-wide infrastructure endeavors. Yet our communities deserve this support — not because the government owes it to us for generations of harm done, but because our elders are people worthy of resources available to the rest of the country. Grandparents deserve to teach children our languages, and they deserve to have heat, electricity and water at home. AI/AN elders deserve to age in their homes, in their communities, without worrying that their death may extinguish part of our heritage.

Our elders deserve the basic modern needs afforded to the rest of America to rebuild our communities and pave a new path for our thriving cultural heritage.