Acculturation has become a popular variable in research on health disparities among certain ethnic minorities, in the absence of serious reflection about its central concepts and assumptions. Key constructs such as what constitutes a culture, which traits pertain to the ethnic versus "mainstream" culture, and what cultural adaptation entails have not been carefully defined. Using examples from a systematic review of recent articles, this paper critically reviews the development and application of the concept of acculturation in US health research on Hispanics. Multiple misconceptions and errors in the central assumptions underlying the concept of acculturation are examined, and it is concluded that acculturation as a variable in health research may be based more on ethnic stereotyping than on objective representations of cultural difference.

As states weaken and public health care deteriorates throughout the developing world, new spaces are opening for civil society groups to fill the gaps of declining health systems. In Mexico, popular health groups have responded to health care decline by building community clinics, establishing health promoter training programs, and opening natural medicine pharmacies. Lower- and working-class women are the primary participants in these groups that use a self-help approach to find practical solutions to local health care problems. However, little is known about participants' circumstances, motivations, or the ideals they embrace. Drawing from women's narratives, I explore the "micropolitics" of women's participation in local health groups. I examine their efforts to reclaim control over the health process as a metaphor for claiming control over their lives. Highlighting the "instrumental effects" of participants' medical encounters and healing relationships, this case illuminates some unintended consequences of health care decline.

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