Accelerated aging and health in people experiencing homelessness in New Mexico: a latent class analysis

People experiencing homelessness (PEH) experience elevated rates of premature mortality and health conditions typically observed in housed individuals 15–20 years older, a phenomenon termed accelerated aging (AA). To investigate which groups of adult PEH are at risk of AA. Guided by the behavioral model for vulnerable populations, we assessed how factors, including physical health, healthcare access, environmental stressors, mental health, and substance use, cluster to create distinct profiles indicative of AA among PEH. Cross-sectional survey data were collected across 11 New Mexico counties (December 2023–March 2024) ​​encompassing both urban and rural areas. A total of 505 people completed the survey and were included in this analysis. Eligibility was defined by the Homeless Emergency Assistance and Rapid Transitions to Housing Act. Latent class analysis (LCA) was conducted using 14 binary indicators spanning six domains: physical conditions, healthcare access, substance use disorders, life events, environmental stressors, and mental health, to identify distinct AA profiles. We examined associations between class membership and homelessness episode length via descriptive statistics, t tests, chi-square tests, and ANOVA. A 4-class solution provided optimal fit (BIC = 7353.16): 1) Healthcare-engaged, low medical complexity (13.7%); (2) Low medical complexity, moderate environmental stress (27.9%); (3) Psychosocial burden with multiple adversities (39.4%); and (4) High medical complexity and healthcare engagement (19.0%). Three classes (1, 3, and 4) comprised 70.5% of the sample and were designated accelerated-aging (AA) phenotypes. Homelessness episode length varied significantly by latent class (ANOVA p = 0.023) but not by binary AA status (Mann–Whitney U p = 0.15). AA represents premature development of age-related conditions and functional decline. The heterogeneous profiles underscore the need for tailored interventions addressing medical needs as well as structural barriers, trauma, and healthcare navigation. Age-based eligibility criteria for geriatric services may miss younger PEHs experiencing premature aging, particularly those with justice involvement or chronic unsheltered homelessness.