Death Literacy in a United States Community: A Cross-Sectional Study

Area of Science:

• Sociology
• Public Health
• Gerontology

Background:

• Death literacy is crucial for end-of-life (EOL) care and planning.
• Understanding community-level death literacy is essential for targeted interventions.
• The Death Literacy Index (DLI) is a tool for assessing this construct.

Purpose of the Study:

• Establish benchmark Death Literacy Index (DLI) scores in a U.S. community.
• Examine demographic, end-of-life (EOL) experience, and spiritual influences on DLI scores.
• Assess the psychometric properties of the DLI for reliability and validity.

Main Methods:

• A cross-sectional survey was administered to a community convenience sample (n=367).
• The Death Literacy Index (DLI) was used to collect data on death literacy.
• Statistical analyses included descriptive statistics, correlational analyses, and structural equation modeling for psychometric evaluation.

Main Results:

• The overall DLI score was 4.87 (scaled 0-10), with Support Groups scoring highest (6.04) and Doing Hands-On Care lowest (3.75).
• Higher DLI scores correlated with older age, widowed status, Medicare, EOL experience, and spirituality.
• Factor analysis confirmed a robust 6-factor model for the DLI with good fit statistics.

Conclusions:

• The DLI is a reliable instrument for measuring death literacy in the U.S. population.
• Demographic factors, EOL experiences, and spirituality significantly impact death literacy.
• Benchmark scores provide a basis for future research and intervention development in death literacy.