This exploratory paper provides an overview of rheumatic diseases (RD) in aged homeless populations in the US and Canada. We analyzed general data on the subject from articles retrieved online. Relatively few studies have focused on this question over the recent years. Our findings indicate that individuals facing housing instability age faster than the general North American population by a difference of 10 to 20 years. This premature aging leads to the occurrence of RDs at a significantly younger age. Arthritis was the most commonly reported condition. Although prevalence was similar as in in the general population, arthritic homeless individuals were 22 years younger in average and more often exhibited a polyarticular clinical presentation. Co-morbidity involving both communicable and non-communicable diseases was constant. Connective tissue disorders such as rheumatoid arthritis (RA) remain common with sometimes a florid symptomatology no more seen in the general population. Finally, the more compounding effects of RD associated with aged homelessness were severe chronic pain and ankylosis, which also resulted in a higher frequency of falls. We hypothesize that the close interactions between rheumatic diseases, chronic pain and falls created a singular pathway to premature death, even years after individuals exit from homelessness. Further multidisciplinary research is needed to explore the ways specific public health programs can be developed to address the needs of this particularly vulnerable population.