Examining Functional Limitation Trajectories Among Adults Experiencing Homelessness Versus the General Adult Population in Los Angeles County.

Abstract

People experiencing homelessness have disproportionately high rates of early-onset geriatric conditions and decades-early mortality. These phenomena are well documented but not well understood, particularly for younger adults experiencing homelessness (e.g., those aged 18-39 years). This cross-sectional study compares functional limitation prevalences in a sample of adults experiencing homelessness with those in the general adult population in Los Angeles County. The Periodic Assessment of Trajectories of Housing, Homelessness, and Health Study indentified adults experiencing homelessness in Los Angeles County (analytic sample n=633); 2019-2023 American Community Survey data defined the adult Los Angeles County population (weighted n=7,790,124). Overall, age-specific, and age- and sex-standardized functional limitation item prevalences were calculated and compared between the two samples. Study participants aged 25-59 years, men, and non-Hispanic Black individualswere overrepresented compared to Los Angeles County adults. Overall and age-specific functional limitations were higher and did not uniformly increase among study participants versus Los Angeles County adults (55% vs 13% reporting any functional limitation, respectively). The age- and sex-standardized prevalence of any functional limitation was 59%-6.2 times higher among study participants versus Los Angeles County adults. This work adds to the literature documenting a substantial functional limitation burden among unhoused populations. Functional limitation prevalences were elevated but showed no consistent trend by age in the Periodic Assessment of Trajectories of Housing, Homelessness, and Health Study; age and sex distribution differences did not explain differences between the two samples.