SIOUX FALLS, S.D. (KELO) — Native American Day is about 32 years old this year.

So how is the state’s Native American population faring on this Oct. 10, Native American Day?

South Dakota has the highest Native American poverty rate in 2022 in the nation, according to World Population Review. About 49% live in poverty.

That’s higher than the national rate of 12.8% in 2021, according to the U.S. Census Bureau. The poverty rate for South Dakota in 2021 was 12.3%

The nine reservations in the state are: Cheyenne River, Crow Creek, Flandreau, Lower Brule, Rosebud, Pine Ridge, Sisseton-Wahpeton, Standing Rock and Yankton.

The state’s Department of Social Services cited these characteristics of the Native American population in the state in 2019: The native population is more likely to have lower household incomes, be in poverty and be without health insurance compared to other South Dakota residents.

The state’s two largest populations are on the Pine Ridge Reservation and the Rosebud Reservation.

The U.S. Census Bureau lists the population of the Pine Ridge Reservation in South Dakota and Nebraska as 19,830 with 4,267 households. The Census lists 2,274 members of the population as white.

The median income in 2020 inflation-adjusted dollars is $33,161. An estimated 41.2% of families live below the poverty level.

The poverty level at Pine Ridge is 53.75% according to the Pine Ridge website. Within Pine Ridge or the Oglala Lakota Nation, a majority of people in one county don’t even reach the poverty line, according to a 2019 testimony before the U.S. House Natural Resource Committee. In Oglala County, more than 51.9% of the population lived below the poverty line.

The estimated population of the Rosebud Reservation is 11,565, according to the Census Bureau.

The Census Bureau estimated that 52.4% of all families were living below the poverty on Rosebud Reservation and off reservation trust land.

The July 2021 estimated census said American Indians made up about 9% of the state’s population. The percentage was 8.4% in the 2020 U.S. Census.

Poor health, short lives

American Indians and Alaska Natives have a lower life expectancy by 5.5 years, according to the National Congress of American Indians.

From 2004 to 2018, heart disease was the No. 1 cause of death for Native Americans, according to the South Dakota Department of Health. It was the leading cause in seven of those years followed by accidents, five years and cancer, three years.

Eleven counties, all with at least some portion in a reservation consistently ranked in the bottom 25% of the state in rankings for health status, health access and health risk behavior, according to a 2016-2020 S.D. DOH Primary Care Needs Assessment.

Those counties are Bennett, Dewey, Mellette, Todd, Buffalo, Jackson, Oglala Lakota, Ziebach, Corson, Lyman and Roberts.

American Indians “continue to die at higher rates than other Americans in many categories, including chronic liver disease and cirrhosis, diabetes mellitus, unintentional injuries, assault/homicide, intentional self-harm/suicide, and chronic lower respiratory diseases,” Indian Health Services said on a disparity section on its website.