Title VII of the 1964 Civil Rights Act made employment discrimination and segregation on the basis of race, ethnicity, or sex illegal in the United States. Previous research based on analyses of aggregate national trends in occupational segregation suggests that sex and race/ethnic employment segregation has declined in the United States since the 1960s. We add to the existing knowledge base by documenting for the first time male-female, black-white, and Hispanic-white segregation trends using private sector workplace data. The general pattern is that segregation declined for all three categorical comparisons between 1966 and 1980, but after 1980 only sex segregation continued to decline markedly. We estimate regression-based decompositions in the time trends for workplace desegregation to determine whether the observed changes represent change in segregation behavior at the level of workplaces or merely changes in the sectoral and regional distribution of workplaces with stable industrial or local labor market practices. These decompositions suggest that, in addition to desegregation caused by changes in the composition of the population of Equal Employment Opportunity Commission monitored private sector firms, there has been real workplace-level desegregation since 1964.

Scholars of employment segregation now recognize that gender, race, and class processes are mutually constitutive. Coupled with new data-collection strategies, understanding of the organization of work and distribution of inequality will improve. The authors explore the strengths and weaknesses of longitudinal establishment data collected by the Equal Employment Opportunity Commission (EEOC), comparing these to other data used to study workplace status processes. Findings both confirm and dispute well-known occupation-based analyses of workplace segregation and lead to similar substantive conclusions. EEOC data are useful for discovering trends in segregation, for locating segregation in spatial, temporal, and industrial contexts, and for combining with organizational data to uncover mechanisms.

The Civil Rights Act of 1964 stands as one of the greatest achievements in U.S. history. Although the law made discrimination illegal, its effectiveness, especially Title VII covering the employment domain, remains highly contested. The authors argue that legal shifts produce workplace racial integration only to the extent that there are additional political pressures on firms to desegregate. They examine fluctuating national political pressure to enforce equal employment opportunity law and affirmative action mandates as key influences on the pace of workplace racial desegregation and explore trajectories of Black-White integration in U.S. workplaces since 1966. Their results show that although federal and state equal employment opportunity pressures had initial successes in reducing racial segregation in workplaces, little progress has been made since the early 1980s. They conclude that racial desegregation is an ongoing politically mediated process, not a natural or inevitable outcome of early civil rights movement victories.

Introduction: There are no validated instruments for measuring healthcare access (HCA). This study aimed to develop a cohesive HCA instrument for cancer survivors and evaluate the factor structure, reliability, and psychometric properties of two HCA domains—Acceptability and Accommodation—that require patient-reported survey data. Methods: This study reports data from three general methodological approaches: (1) concept elicitation using focus groups with 32 cancer survivors (63% Black, 18% Hispanic) to inform the development of new HCA survey items; (2) refining the new survey items using cognitive interviews with seven ovarian cancer survivors (n = 3 Black, n = 1 Hispanic) and pilot testing with 54 ovarian cancer survivors (74% White, 14% Black); and (3) psychometric evaluation of the Acceptability and Accommodation items among 333 ovarian cancer survivors (82% White, 13% Black). Multiple model structures were assessed for each HCA dimension using confirmatory factor analysis methods, and composite reliability was estimated for selected models. Results: In focus group discussions, cancer survivors expressed challenges navigating cancer treatment across multiple HCA domains, with the Acceptability domain (quality of patient–provider interaction) being the most salient across all racial groups. Lack of empathy, compassion, and poor communication overshadowed positive aspects of providers’ specialty, experience, or reputation. Cognitive interviews and pilot testing of new HCA survey items helped to clarify the language of specific items and refine the recruitment and consent process for implementation of the survey. In psychometric evaluation, the Accommodation domain (convenience and organization of services) was best accounted for by a two-factor structure: satisfaction with care and access to support services (comparative fit index (CFI) = 0.99). For the Acceptability domain, all fit indices supported the retention of a five-factor higher-order model (CFI = 0.96). Composite reliability estimates were >0.80 for all latent factors in the two-factor Accommodation model and the higher-order Acceptability model. Conclusions: Empirical evidence supports the utility of standardized measures of Accommodation and Acceptability using self-reported survey items, which will contribute to the better characterization of HCA dimensions among diverse cancer survivors.

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