Using examples from community nutrition, this project shows that health is best understood through an ecological systems model. Furthermore, this model contains both an ethical and epistemological imperative to generate health-related knowledge through participatory action research. First the ecological systems model of health is simultaneously described and illustrated with examples from nutrition. This model is one that understands individual well-being as the result of complex interactions within and among nested systems of environmental influence. Thinking about health this way acknowledges the impact of stress, social support, membership in community organizations, the built environment, agricultural subsidies, genetically modified organics and more on the health outcomes of individuals. Also, this model of health highlights a number of the positive, multi-level effects that could come about if local food systems were comprehensively integrated into nutrition assistance programs. The analysis next examines the implications of such a model that acknowledges the agency of individuals to impact both their physical health and larger systems of which they are a part. These elements of ecological systems theory demand research that is both participatory, so that the divisions between researchers and subjects are renegotiated, and action-oriented, so that research actively works for systemic change.
Finally, my work evaluating the Oxford Farmers Market Uptown's (OFMU) Electronic Benefit Transfer (EBT) federal food assistance program is presented as a case-study. Using Empowerment Evaluation (EE), a participatory research technique, to identify and address barriers toward using EBT at OFMU, it became clear that OFMU could provide nutritious, affordable, and culturally appropriate foods to low-income members of the Oxford community, given more targeted advertisement and outreach. EE provided flexible and effective tools for evaluation but fell short of comprehensively incorporating consumers into the evaluation. My own position as a learner who was eager to embrace the “researcher as subject” model enriched and informed the results. Taken seriously, the lessons of ecological systems theory and participatory action research offer a paradigm-shift in health promotion that truly works for the well-being of the whole individual and the transformation of the environments that they call home.