Report

A Time to be Born and a Time to Die: Exploring the

Determinants of Death Anxiety among University Students

in a Western Canadian City

Henry P. H. Chow

Department of Sociology & Social Studies, University of Regina, Regina, SK, Canada

Address correspondence to Henry P. H. Chow, Department of Sociology & Social Studies,

University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2 Canada. Tele:

306.585.5604. Fax: 306.585.4815. E-mail: Henry.Chow@uregina.ca

Abstract

Keywords: Canada, death anxiety, purpose in life, religiosity, university students

INTRODUCTION

Death anxiety, or fear of death, can be defined as the emotional distress and insecurity

heightened by encounters with death or thoughts of death (Kastenbaum, 2000). It encompasses a

cluster of attitudes which is characterized by threat, fear, unease, discomfort, irritation, pain, and

other negative emotional reactions, as well as anxiety as a type of diffuse fear without a

conspicuous object (Neimeyer, Moser, & Wittkowski, 2003). Although death anxiety is common

in the general population, most individuals are able to navigate daily life without being

overwhelmed by it. The experience of death anxiety is not in itself a negative experience. In fact,

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Firestone (1993) posits that individuals may place more value on their lives by feeling a degree

of death anxiety which is not overwhelming. When death anxiety becomes excessive, however,

Niemiec and Schulenberg (2011) contend that it can be both “functionally debilitating” and

“inhibiting of personal growth.”

The negative effects of heightened death anxiety have been well-documented. Earlier

studies have shown that individuals who displayed a higher level of death anxiety were more

likely to report low subjective well-being, less psychological endurance and ego strength,

depression, general anxiety, distress, introversion, low self-esteem, low need for achievement,

withdrawal from life, and more physical health problems (Firestone & Catlett, 2009; Hart,

Shaver, & Goldenberg, 2005; Rappaport, Fosslera, Brossa, & Gildena, 1993; Strachan et al.,

2007; Wong, Reker, & Gesser, 1994; Wu, Tang, & Kwok, 2002).

A growing body of research has explored the correlates of death anxiety, focusing on age,

gender, and religion. However, empirical findings appear to be rather conflicting. Regarding

gender, while it has been demonstrated that women tended to report higher levels of death

anxiety than men (Abdel-Khalek & Al-Kandari, 2007; Jackson, 2008; Lester, Templer, & Abdel-

Khalek, 2007; Peterson & Plehn, 1999; Power & Smith, 2008; Russac, Gatliff, Reece, &

Spottswood, 2007; Schumaker, Barraclough, & Vagg, 2001; Suhail & Akram, 2002), some

studies found no gender differences (Fortner & Neimeyer, 1999; Wong et al., 1994; Wu et al.,

2002). With respect to age, prior studies have shown a positive (DePaola, Griffin, Young, &

Neimeyer, 2003; Mullins & Lopez, 1982; Viney, 1984), an inverse (Jackson, 2008; Kastenbaum,

1992; Russac et al., 2007; Thorson & Powell, 1994; Tobin, 1996), or a curvilinear (Kastenbaum,

2001; Neimeyer, Wittkowski, & Moser, 2004; Thorson & Powell, 1994) relationship between

age and death anxiety. Concerning religion, earlier studies have found no association (Abdel-

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Khalek & Lester, 2009; Alvarado, Templer, Bresler, & Thomas-Dobson, 1995; Démuthová,

2013), a positive relationship (Franks, Templer, Cappelletty, & Kauffman, 1990–1991), or an

inverse association (Harding, Flannelly, Weaver, & Costa, 2005; Henrie & Patrick, 2014;

Roshdieh, Templer, Cannon, & Canfield, 1998-1999; Suhail & Akram, 2002; Wen, 2010) with

death anxiety. These conflicting findings may arise from the different operationalization and

measurement of the various variables (e.g., unidimensional vs. multidimensional constructs) and

the use of different samples (e.g., clinical vs. non-clinical samples) with various ethno-cultural

backgrounds and life circumstances.

In addition, it should be noted that a great deal of research attention has been given to

elderly people (Azaiza, Ron, Shoham, & Gigini, 2010; Besser & Priel, 2008; Cicirelli, 2006; Wu

et al., 2002), patients facing a serious or terminal illness (Abdelbratt & Strang, 2000; Elahi,

2007; McGrath, 2003; Otoom, Al-Jishi, Montgomery, Ghwanmeh, & Atoum, 2007; Tang,

Chiou, Lin, Wang, & Liand, 2011), individuals who have been exposed to traumatic life events

(Ens & Bond Jr., 2005; Hoelterhoff & Chung, 2013), and helping and health professionals, such

as nurses (Chen, Del Ben, Fortson, & Lewis, 2006; Peters et al., 2013), hospice workers (Jonasen

& O’Beirne, 2015; Mercer & Feeney, 2009), medical doctors (Cochrane, Marvin, Levy, Fryer, &

Oglesby, 1991; Viswanathan, 1996), and funeral service workers (Harrawood, 2009-2010; Keith,

1996-1997; Thorson & Powell, 1996).

Previous studies examining the fear of death among university students tended to focus

on those pursuing studies in specific professional fields, such as medicine (Hegedus, Zana, &

Szabo, 2008; Kaklauskaite & Vonzodiene, 2015), nursing (Abdel-Khalek & Tomás-Sábado,

2005; Chen et al., 2006; Venegas, Alvarado, & Barriga, 2011), counselling (Harrawood,

Doughty, & Wilde, 2011), and human services (Eshbaugh, Gross, & Satrom, 2010; McClatchey

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& King, 2015). Indeed, relatively few studies involved the use of the general student populations

(Arnold, 2007; Nienaber & Goedereis, 2015) and only very limited research attention has been

devoted to university students in Canada (Lonetto, Mercer, Fleming, Bunting, & Clare, 1980;

McGrory, 1977; Power & Smith, 2008). To extend this line of research and to fill a gap in the

literature, the primary purpose of this paper is to explore the extent to which young adults are

fearful of death and to disentangle the major correlates of their death anxiety using a sample of

undergraduate students in a western Canadian city.

METHOD

Sample

Data for this research were collected as part of a larger investigation into social attitudes

and general well-being among university students in a western Canadian city (Chow, 2008).

Using a convenience sample, a total of 501 undergraduate students took part in a self-

administered questionnaire survey. Approval from the university’s Ethics Review Board was

obtained prior to administering the survey. With the co-operation of the faculty members in the

Department of Sociology and Social Studies, self-administered questionnaires were distributed to

Sociology and Social Studies classes. Students were informed both in writing and verbally that

participation was voluntary and that return of their completed survey would serve as their

participation consent. They were also assured of anonymity and confidentiality. The survey took

approximately 20 minutes to complete and no incentive was provided. Although the respondents

were recruited from Sociology and Social Studies classes, it should be emphasized that these 501

students were officially registered with various faculties and schools, including Business

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Administration, Arts, Education, Engineering, Fine Arts, Journalism, Kinesiology, Science, and

Social Work.

The sample comprised 147 (29.7%) male and 348 (70.3%) female students with a mean

age of 21.42 years (SD = 4.91). Caucasian students (n = 443, 89.9%) and Canadian citizens (n =

484, 98.0%) constituted an overwhelming majority of the sample. A sizable proportion of the

respondents were registered with the Faculties of Arts (n = 276, 55.4%), Business

Administration (n = 49, 9.8%), and Science (n = 49, 9.8%). With respect to marital status, most

were never married or single (n = 426, 86.1%). Slightly more than two-thirds of the respondents

indicated either Protestantism (n = 138, 30.1%) or Catholicism (n = 173, 37.8%) as their

religious affiliation. Concerning parents’ educational attainment, over half of the sample had a

father (n = 251, 53.0%) or a mother (n = 273, 56.6%) with post-secondary education. As well,

over half of the sample (n = 257, 56.7%) reported an annual family income of more than $

60,000.

Statistical Analysis

Data was analyzed using the Statistical Package for the Social Sciences. Both descriptive

and inferential analyses were conducted. Cronbach’s alpha reliability test was used to investigate

the internal consistency of all scales used. A multiple ordinary least-squares (OLS) regression

model was constructed to identify the key determinants of death anxiety.

MEASURES

Dependent Variable

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 Death anxiety. The dependent variable, death anxiety, was a composite score (M = 24.98,

SD = 5.57) measured using a modified version of Templer’s (1970) Death Anxiety Scale.

Respondents were asked to express their degree of agreement or disagreement with nine

statements on a five-point scale ranging from 1 (strong disagree) to 5 (strongly agree): (1) The

thought of death seldom enters my mind (M = 2.98, SD = 1.15); (2) I am very much afraid to die

(M = 2.62, SD = 1.19); (3) I am often distressed by the way time flies so very rapidly (M = 3.09,

SD = 1.09); (4) The subject of life after death troubles me a lot (M = 2.33, SD = 1.08); (5) I often

think about how short life really is (M = 3.00, SD = 1.17); (6) I feel that the future holds nothing

for me to fear (M = 3.17, SD = 1.103); (7) I fear dying a painful death (M = 2.99, SD = 1.26); (8)

I am preoccupied with the fear of having a serious illness (M = 2.19, SD = 1.01); and (9) I see

death as a passage to an eternal and blessed place (M = 3.12, SD = 1.21). The coding for items 1,

6, and 9 has been reversed so as to create a scale that a higher mean value would reflect higher

levels of death anxiety. This scale was found to be internally consistent, with a Cronbach’s alpha

reliability coefficient of .70.

Independent Variables

Religiosity was measured using items adapted from the Religious Orientation Scale

which was developed by Allport and Ross (1967). The additive score of this intrinsic-extrinsic

religiousness scale (M = 12.84, SD = 5.48) was based on respondents’ degree of agreement or

disagreement with the following items assessed on a five-point scale (1 = strong disagree; 2 =

disagree; 3 = uncertain; 4 = agree; 5 = strongly agree): (1) I believe in God/absolute being (M =

3.84, SD = 1.23); (2) I attend religious service regularly (M = 21.2, SD = 1.40); (3) I pray on a

regular basis (M = 2.47, SD = 1.43); (4) I read religious texts regularly (M = 1.90, SD = 1.16);

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and (5) I try hard to carry my religion over into all my other dealings in life (M = 2.49, SD =

1.33). This scale has a Cronbach’s alpha reliability coefficient of .89.

Purpose in life was measured using a modified version of Robbins and Francis’ (2000)

Purpose in Life Scale. The additive score (M = 40.87, SD = 5.84) was based on respondents’

degree of agreement or disagreement with the following ten statements using a five-point scale

(1 = strong disagree; 2 = disagree; 3 = uncertain; 4 = agree; 5 = strongly agree): (1) My life has

clear goals and aims (M = 3.84, SD = .85); (2) I feel my life has a sense of direction (M = 3.96,

SD = .76); (3) I feel my life has a sense of meaning (M = 4.04, SD = .766); (4) My personal

existence is full of purpose (M = 3.92, SD = .81); (5) There are things I still want to achieve in

my life (M = 4.65, SD = .57); (6) My personal existence is full of direction (M = 3.86, SD = .82);

(7) I feel my life has a sense of purpose (M = 4.04, SD = .77); (8) My personal existence is full of

meaning (M = 3.91, SD = .82); (9) I feel my life is going nowhere (M = 1.69, SD = .83); and (10)

There is no purpose in what I am doing (M = 1.63, SD = .85). The coding for the last two

statements was reversed so that a higher composite score would reflect a stronger sense of life

purpose. This scale was found to be internally consistent, with a Cronbach’s alpha reliability

coefficient of .92.

Life satisfaction was measured using a five-item scale developed by Diener, Emmons,

and Griffin (1985). Respondents were asked to express their degree of agreement or

disagreement with the following statements using a five-point scale (1 = strong disagree; 2 =

disagree; 3 = uncertain; 4 = agree; 5 = strongly agree): (1) In most ways my life is close to my

ideal (M = 3.62, SD = .826); (2) The conditions of my life are excellent (M = 3.73, SD = .88); (3)

I am satisfied with my life (M = 3.87, SD = .81); (4) So far I have gotten the important things I

want in life (M = 3.53, SD = .99); and (5) If I could live my life over, I would change almost

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nothing (M = 3.28, SD = 1.13). This additive scale (M = 18.04, SD = 3.38) has a Cronbach’s

alpha reliability coefficient of .77.

Perceived family support (M = 4.03, SD = .98) was based on respondents’ degree of

agreement or disagreement with the statement “The support I receive from family members meet

my needs” using a five-point scale (1 = strong disagree; 2 = disagree; 3 = uncertain; 4 = agree; 5

= strongly agree).

Perceived support from friends (M = 3.77, SD = .87) was based on respondents’ degree

of agreement or disagreement with the statement “The support I receive from my significant

other meet my needs” measured on a five-point scale ranging from 1 = strong disagree to 5 =

strongly agree.

Loneliness (M = 2.71, SD = 1.13) was a single item based on respondents’ feeling of

loneliness in the past month measured on a five-point scale (1= never to 5 = very frequently).

Self-image (M = 3.65, SD = .95) was a single item measured on a five-point scale ranging

from 1 (very dissatisfied) to 5 (very satisfied).

Physical health (M = 3.83, SD = .92) was measured on a five-point scale (1 = very

dissatisfied to 5 = very satisfied).

With respect to socio-demographic variables, sex (1 = male, 0 = female), religious

affiliation (1 = Protestant and Catholic; 0 = other), ethnic background (1 = Caucasian; 0 = other),

and marital status (1 = single or divorced; 0 = other) were dichotomous variables. Age (M =

21.42, SD = 4.91) was measured as a continuous variable. Socio-economic status (M = 3.41, SD

= .81) was measured on a five-point scale (1 = low to 5 = high).

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 FINDINGS

Descriptive Statistics

The descriptive statistics for the nine items measuring death anxiety are displayed in

Table 1. The mean values ranged between 2.19 and 3.09, indicating that respondents

demonstrated a moderate level of death anxiety. About two-fifths of the respondents admitted

that they were “often distressed by the way time flies so very rapidly” (n = 208, 41.9%) and

thought about “how short life really is” (n = 212, 42.7%). Slightly more than a quarter of the

sample (n = 131, 26.3%) indicated that they were “very much afraid to die” (n = 131, 26.3%) and

more than two-fifths expressed that they feared “dying a painful death” (n = 218, 43.9%). On a

more positive note, more than two-fifths of the respondents (n = 212, 42.8%) agreed or strongly

agreed with the statement “the future holds nothing for me to fear” and slightly less than two-

fifths of the sample (n = 197, 39.7%) also expressed agreement with the item “I see death as a

passage to an eternal and blessed place.”

Multivariate Analysis: Determinants of Death Anxiety

To explore the factors influencing fear of death among the respondents, a multiple OLS

regression model was constructed. A total of thirteen predictor variables, including sex, age,

socio-economic status, religious affiliation, marital status, loneliness, religiosity, academic

performance, social support, physical health, purpose in life, self-image, and life satisfaction

were included in the regression model.

The multiple OLS regression model, as shown in Table 2, was found to be significant (F

(14, 453) = 9.339, p < .001) and explained 20.0% of the variation in death anxiety. Sex ( =

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.202, p < .001), socio-economic status ( = .095, p < .05), ethnic background ( = .095, p <

.05), religiosity ( = .146, p < .01), life purpose ( = .172, p < .001), loneliness ( = .201, p

<. 001), and self-image ( = .120, p < .05) were found to be significantly related to death

anxiety. In particular, females, non-Caucasians, and those who were satisfied with their self-

image, reported a higher socio-economic status, demonstrated to be more religious, expressed a

higher level of loneliness, and scored lower on the purpose in life scale were found to exhibit a

higher level of death anxiety.

DISCUSSION AND CONCLUSION

Using survey data collected from university students in a western Canadian city, this

paper has examined the students’ fear of death and has disentangled the factors that accounted

for the variation in death anxiety level. The findings reveal that students reported a moderate

level of death anxiety. With respect to the key factors affecting respondents’ death anxiety, the

present analysis has corroborated findings from most previous studies that females tended to

report a higher level of death anxiety (Abdel-Khalek, 2002; Abdel-Khalek & Al-Kandari, 2007;

Kastenbaum, 2000; Lester et al., 2007; Pierce Jr., Cohen, Chambers, & Meade, 2007; Power &

Smith, 2008; Russac et al., 2007; Suhail & Akram, 2002). In fact, researchers have attributed the

gender difference to women being more emotionally expressive than men (Dattel & Neimeyer,

1990; Fortner & Neimeyer, 1999). This analysis also lends credence to the vitality of religiosity

on death anxiety (Harding et al., 2005; Henrie & Patrick, 2014; Krause, 2015; Thorson, 1991;

Wen, 2010). Individuals who are religious are perhaps more active in religious participation and

are more likely to have a stronger social support network.

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 Congruent with prior studies, purpose in life was found to be predictive of death anxiety.

Specifically, it has been well-documented that individuals with clear life purposes tended to have

lower levels of death anxiety (Ardelt, 2003; Chan, 1990; Drolet, 1990; Rappaport et al., 1993;

Viswanathan, 1996; Wong et al., 1994). Having a clear purpose in life, including meaningful

aims and goals for the future, is regarded as an indicator of the desire to survive (Fortner &

Neimeyer, 1999). Van Hiel and Vansteenkiste (2009) also ascertained the association between

low death anxiety and intrinsic life goals, such as establishment of meaning relationships,

societal contribution, and personal development.

Furthermore, loneliness, as an indicator of respondents’ psychological wellness, was also

found to be associated with death anxiety. This finding is consonant with earlier studies

demonstrating the negative impact of psychological well-being on death anxiety (Pinson, 2010).

Self-image, as a measure of self-evaluation, emerges as another significant determinant which

bears an inverse relationship with death anxiety. Stated differently, respondents who were

dissatisfied with their self-image (i.e., negative evaluation of themselves) were shown to be more

anxious about death. There is strong empirical evidence demonstrating a negative correlation

between death anxiety and self-evaluation (Abeyta, Juhl, & Routledge, 2014; Brewer, 2002;

Cotter, 2003; Harmon-Jones, Simon, Greenberg, Pyszczynski, & McGregor, 1997; Jackson,

2008; Pyszczynski, Greenberg, Solomon, Arndt, & Schimel, 2004).

With respect to ethnic background, the finding that non-Caucasian students scored higher

on death anxiety concurs with earlier studies involving ethnically diverse elderly samples

(Bowling, Iliffe, Kessel, & Higginson, 2010; DePaola et al., 2003; Thorson, Powell, & Samuel,

1998), underscoring the importance of culture on individuals’ views on death-related issues.

Finally, despite the commonly held view that socio-economic status buffers against death

11
anxiety, a higher level of death anxiety was displayed by respondents who indicated a higher

socio-economic status. Additional studies will be needed to further clarify the relationship

between these two variables.

In light of the fact that terrorist attacks (Institute for Economics & Peace, 2015; Nan &

Sheppard, 2011) and mass shootings at institutions of higher education (Blair & Schweit, 2014;

Newman & Fox, 2009) in the United States and around the world have become tragically more

common, university students would inevitably experience a heightened sense of vulnerability and

greater fear of death. Notably, various recent studies have revealed students’ fear and concerns

over their safety (Chekwa, Thomas Jr., & Jones, 2013; Horton, 2015; Misis, Bush, & Hendrix,

2016; Schildkraut, Elsass, & Stafford, 2015; Shahzad, 2014) and have demonstrated the

strenuous efforts made by educational institutions to step up campus security measures and to

develop response plans to deal with those emergency situations (Fox & Savage, 2009; Kapucu &

Khosa, 2012; Schafer, Lee, Burruss, & Giblin, 2016). It is therefore vital for institutions of

higher learning to provide formal (i.e., academic courses) and informal (i.e., seminars and

workshops) death education so as to better prepare their students for those unexpected traumatic

events and to reduce their death fear and anxiety.

The findings from this investigation may be utilized by academic advisors, health

professionals, and counselors to aid in the design of interventions and support services that might

serve to enhance students’ quality of life and to reduce their level of anxiety. However, the

results must be considered in light of some potential limitations of the analysis. As this

investigation was carried out on a convenience sample of undergraduate students at only one

university in a western Canadian city, the findings should be interpreted with caution. The

reliance on cross-sectional data precludes interpretation of causality. Future research should

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investigate post-secondary student populations in other geographical locations. Additional

exploration of variation across types of students (e.g., minority students) and institutions (i.e.,

college vs. university) and of variables such as life circumstances and experiences with death and

dying would be informative.

Acknowledgements

This study was conducted under the auspices of the Department of Sociology and Social

Studies at the University of Regina. A considerable debt is owed to Theresa Bigayan, Tara

Busch, Barbara Cabrera, Joshua Freistadt, Susan Hanna, Susan Keys, Kelly-Ann McLeod, Dale

Partridge, Christall Paul, Theresa Pinay, Shelley Skelding, Hiroko Sugimoto, Jennifer Youck,

and Greg Young for their research assistance, and to Yau-tsang Chan, Angel Chow, Christie

Chow, Christopher Chow, Simon Kwan, Sutton Cheung, Stephen Tam, Bosco Li, Chap Wong,

and Thomson Yu for their unwavering support. An earlier version of this paper was presented at

the annual meeting of the Canadian Sociological Association (Congress, 2012), University of

Waterloo, Kitchener-Waterloo, Ontario, Canada.

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Table 1. Descriptive statistics for items measuring death anxiety

1 2 3 4 5

n (%) n (%) n (%) n (%) n (%) M

(SD)

1. The thought of death seldom 46 (9.3) 153 101 157 40 3.02

enters my mind (30.8) (20.3) (31.6) (8.0) (1.15)

2. I am very much afraid to die 89 (17.9) 179 99 93 38 2.62

(35.9) (19.9) (18.7) (7.6) (1.19)

3. I am often distressed by the 26 (5.2) 153 110 164 44 3.09

way time flies so very rapidly (30.8) (22.1) (33.0) (8.9) (1.09)

4. The subject of life after death 118 193 105 64 17 2.33

troubles me a lot (23.7) (38.8) (21.1) (12.9) (3.4) (1.08)

5. I often think about how short 54 (10.9) 140 91 175 37 3.00

life really is (28.2) (18.3) (35.2) (7.4) (1.17)

6. I feel that the future holds 33 (6.7) 115 135 160 52 2.83

nothing for me to fear (23.2) (27.3) (32.3) (10.5) (1.10)

7. I fear dying a painful death 69 (13.9) 136 74 165 53 2.99

(27.4) (14.9) (33.2) (10.7) (1.26)

8. I am preoccupied with the fear 126 225 87 45 14 2.19

of having a serious illness (25.4) (45.3) (17.5) (9.1) (2.8) (1.01)

9. I see death as a passage to an 72 (14.5) 55 172 135 62 2.88

eternal and blessed place (11.1) (34.7) (27.2) (12.5) (1.21)

(1 = Strongly disagree; 2 = Disagree; 3 = Uncertain or Not applicable; 4 = Agree; 5 = Strongly agree)

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Table 2. Unstandardized and standardized ordinary least-squares regression coefficients for

effects of socio-demographic & background variables on death anxiety

b 

1. Sex 2.465 .202 ***

2. Age .058 .051

3. Socio-economic status .655 .095 *

4. Marital status .768 .044

5. Ethnic background 1.644 .095 *

6. Religious affiliation .851 .071

7. Religiosity .148 .146 **

8. Loneliness .997 .201 ***

9. Perceived family support .064 .011

10. Perceived support from friends .246 .038

11. Purpose in life .164 .172 ***

12. Life satisfaction .154 .093

13. Self-image .702 .120 *

14. Physical health .085 .014

(Constant) 41.799

F 9.339 ***

R² .224

Adjusted R² .200

N 501

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* p < .05; ** p < .01; *** p < .001

22