Work–Family Conflict and Depression Among Healthcare Workers: The Role of Sleep and Decision Latitude

Background: Healthcare workers report a higher incidence of depression than the general population. Work–family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work–family conflict into depression. Methods: In 2018, a cross-sectional survey was collected from healthcare workers ( n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants’ work–family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. Findings: There was a significant association between work–family conflict and depression (β = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family–conflict and depression was stronger among workers with low decision latitude. Conclusions: Depression was prevalent among healthcare workers and was associated with work–family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association. Application to Practice: Evidence-based interventions seeking to alleviate the effect of work–family conflict and improve healthcare workers’ mental health should consider promoting employee sleep quality and improving employees’ decision-making on the job.