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

This study investigated death literacy within a United States (U.S.) community using the Death Literacy Index (DLI). Aims: (1) establish benchmark DLI and subscale scores, (2) examine demographic variability, end-of-life (EOL) experience, and spirituality, (3) assess psychometric properties of DLI. A cross-sectional survey using the DLI was conducted with a community convenience sample. The sample (n = 367) was 75% White, 70% female, with a mean age of 53 years. The overall DLI score was 4.87 (scaled 0-10), with the highest subscale score in Support Groups (6.04) and the lowest in Doing Hands-On Care (3.75). Higher scores are associated with older age, being widowed, Medicare, EOL experience, and spirituality. Factor analysis and confirmatory factor analysis via structural equation modeling supported the 6-factor model with good fit statistics. Strong internal consistency and subscale reliability confirmed the DLI as a reliable instrument for measuring death literacy in the U.S.