Abstract The elderly population in rural communities is growing. Rural populations generally experience excessive deficiencies in health care access, social services, and other goods and services needed for healthy living. An ethnographic study of multicultural elderly participants from a rural county in New Mexico was completed to explore the participants' definitions of health, health care perceptions, and health care needs. Several key issues regarding health care were identified, including the escalating cost of prescriptions, limited access to primary health care and specialty care, and social isolation and loneliness. However, despite these limitations, existing strengths and assets were also identified: elders' knowledge about sustaining health in austere conditions and caring for the sick using simple measures; an existing group of dedicated professional nurses applying their own and others' knowledge to the challenge of health care; and a preexisting community-based action group working to decrease fragmentation of services, streamline delivery of services, and work with legislators on funding priorities. Building on these strengths can provide the keys to the puzzle of transforming the current health care environment and improving inadequate health care for these elderly rural community members.