Death literacy as relational capability: Pathways from social capital to emotional support

Death literacy not only refers to the knowledge and skills of individuals; there is emerging evidence that death literacy is relational and is deepened via social networks and within communities. Exploring these relationships can improve our understanding of pathways that influence death literacy and public health palliative care initiatives.

To examine how community-level resources (social capital) influence perceived emotional support, and to test theoretically motivated mediators-including community openness to conversations about death, participation in end-of-life activities, and death literacy (as measured by the DLI-R).

Cross-sectional survey (N = 831) of adults aged 18+ in the Australian community. A mixed-link generalised structural equation model estimates pathways from social capital to perceived emotional support, via community openness (talking), participation as mediators of death literacy (measured by the DLI-R). Indirect effects and proportions mediated were obtained via BCa bootstrap (5,000 replications). Robustness checks compared alternative orderings.

The total association of social capital with support was β≈0.305. About 35.1% (95% CI 24.6-45.6%) was mediated; 64.9% (54.4-75.4%) was direct. Structural pathways indicated that higher social capital was associated with increased conversation climate (β=0.255***), which in turn was associated with increased participation in end-of-life activities (logit β=0.794***; OR≈2.21) and higher death literacy (β=0.524***). Death literacy was also associated with higher perceived emotional support (β=0.140***).

Feeling supported at the end of life (EoL) is influenced not only by how socially connected communities are, but by what people are able to understand, talk about, and act on death and dying. Open, everyday conversations about death matter and contribute to this, because they provide an opportunity to build understanding and because they signal willingness to support. This highlights two practical ways to grow compassionate communities, strengthen death literacy and socialising conversations about end of life alongside social connectedness.