For many people of the Oglala Lakota Nation, poverty is a fact of life whether they live on or off the reservation.
"Most of the people left homes to be looking for work and they're on Welfare out there, but what's the difference? Over here there's a Welfare check, too," Pine Ridge grandfather John Long Sr. said.
John Long Sr. is the patriarch of the Long household, located in the East Ridge housing unit in Pine Ridge. He and his wife share a home with their daughter, Christine, along with close to a dozen grandchildren and great-grandchildren.
Although having such a close knit family comes with many rewards, Christine says that raising so many kids isn't always easy.
"No it's not, it's hard. Takes a lot of patience," Christine Long said.
Even though Long works for the tribe and both of her parents help out with their social security benefits, she still has to make some tough choices because there's just not enough to go around.
"The little ones eat first, and then the elderly eat next, and then the older children are the ones to eat last. And if we don't have enough, usually it's the older children that have to wait, or just bear with it," Christine said.
"Most of the time there's nothing left over, especially when the kids are growing up and eating more. That's where the bite takes all the dollar bills out the door," John said.
Delores Starr is the research director for the OST Smiles project, which has been tracking the dental health and nutrition of close to 250 Lakota families on the reservation for more than three years. She says the Long family's situation isn't unique.
"Whatever they could afford is what they got. We would like to have them on fruits and vegetables and a well-balanced diet, but they bought what they could afford," Starr said.
For many families, that means relying on canned and heavily processed food, which can lead to health problems.
"Diabetes has never been a problem but it seems to be a problem and it seems to be getting worse," Starr said.
The Long family receives federal surplus food once a month and is able to incorporate fresh vegetables into some meals, but it's still not enough. Christine has had to make some tough decisions, including sending six of her children out-of-state.
"It hurts, but then I know that they will be helped out at the boarding school because we always run out of money to wash clothes. We always run out of money for diapers. Food has a high budget but we still run out, so in the best interest of my children I made the decision to send them to boarding schools," Christine said.
"It's just kind of a scary thing for us to see our own people struggle through, and I don't know what the solutions are," Starr said.
For the Long family, education could be the first step. Christine dreams of earning a college degree and getting a higher paying job that could bring her family back together and ensure there's healthy food for everyone.
"I just know I need to start with myself, go through college, hopefully get a degree, and hopefully that will inspire my children to do the same thing so they won't end up in this situation," Christine said.
Being able to afford food isn't the only challenge facing people on Pine Ridge. The reservation, which is larger than the states of Delaware and Rhode Island combined, has just one full-grocery store and no food pantries.