Usually means: Worn out, shabby, financially struggling.
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We found 9 dictionaries that define the word down at the heel:

General (6 matching dictionaries)
  1. down-at-the-heel, down at the heel: Merriam-Webster
  2. down-at-the-heel: Oxford Learner's Dictionaries
  3. down-at-the-heel: Cambridge Advanced Learner's Dictionary
  4. down at the heel: Wiktionary
  5. down-at-the-heel, down at the heel: Dictionary.com
  6. down-at-the-heel: TheFreeDictionary.com

Medicine (1 matching dictionary)
  1. down at the heel: Merriam-Webster Medical Dictionary

Miscellaneous (2 matching dictionaries)
  1. down-at-the-heel: A Word A Day
  2. down-at-the-heel: Idioms

Definitions from Wiktionary (Down at the heel)

adjective:  Alternative form of down at heel [(literally, of footwear) In poor condition, especially due to having worn heels; worn-out, shabby.]

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