Anderson's (1996) examination of empowerment is based upon her work with first-generation immigrant women with chronic illnesses. Her explora¬tion of empowerment underscores the role of social and structural conditions that foster or impede empowerment. In this regard she draws upon Sherwin's (1992) conceptualization of empowerment, and notes, "Empowerment is an outcome of change in fundamental structures and relations of power, rather than through individual actions alone" (Anderson, 1996, p. 698). Anderson goes on to argue that conditions for empowerment include changes in the ways the health care provider-patient encounter is constructed but also rec¬ognition of and change within the organizational structures that constrain professionals' and patients' capacities to manage illness and in many instances locate responsibility for care with the individual.