Spring 2026
Home Is Where the Health Is
By Shelby Crosier
Illustration by Alex Foster
On This Page
Exploring the often-invisible ways that public health keeps us well in the place where we spend most of our time—our homes.
Home Is Where the Health Is
The amount of time Americans spend at home has been increasing over the past 25 years, especially since 2020. That means that maintaining a healthy home environment is more important than ever. Public health helps us achieve it.
Clean drinking water is readily available throughout the country because of the Safe Drinking Water Act. The rate of sudden infant death syndrome in the U.S. dropped by 50% after the Back to Sleep campaign raised awareness about safe infant sleep. The U.S. Consumer Safety Commission banned lead-based paint in 1978, protecting future generations of children from in-home lead poisoning. All of that and more is thanks to decades of research advancements, policy progress, and the tireless efforts of public health professionals.
Every room in your home contains potential hazards, but they also reveal the unsung public health interventions that keep us safe.
The Bathroom
A typical bathroom can carry hidden health hazards. Lotions, shampoos, and makeup might contain hormone-disrupting chemicals. Full bath tubs pose a drowning risk for small children, and spilled water can lead to falls. High humidity is often accompanied by mold. And appliances like hair dryers can cause electrocution if exposed to water. But bathrooms also showcase public health innovations in clean water accessibility, sanitation and waste management, hygiene, and dental health.
WASH Starts in the Bathroom
The bathroom is likely the first stop of the day after your morning alarm goes off. It is also where some of the most fundamental functions of public health are on display. Access to clean water for drinking, hand-washing, and dental hygiene, plus safe waste disposal systems, are crucial to keeping us healthy.
“We don’t appreciate what a miracle our sanitation infrastructure is. Without it, we would live in a much smellier, dirtier, and more contaminated environment,” says Matthew Freeman, PhD, Asa Griggs Candler Professor of Environmental Health. “The first piped water and sewer systems in Atlanta were built only 150 years ago. We should not underestimate their importance, not only for our personal comfort, but for public and environmental health.”
The U.S. is built on a robust, but mostly invisible, infrastructure that pipes water and waste to and from homes across the country. When most Americans flush their toilets, wastewater is carried away into the sewer system, where it gets treated and cleaned before eventually being released back into local waterways. This water treatment system ensures that the pathogens in human waste are carried away and neutralized before they ever have a chance to make us sick.
A separate, equally important system brings in the clean water that appears as if by magic when you turn on the bathroom tap.
Washing your hands may seem second-nature, but according to Freeman, it is “one of the most cost-effective public health behaviors that people can do.” Hand hygiene is vital to prevent catching and spreading respiratory illnesses like the flu and diarrheal illnesses.
“What makes hand hygiene so effective is also what makes it boring and hopefully routine: All you need is water and soap in the right place at the right time,” says Freeman. “It seems so obvious, but that is only because of the work of the local utilities, household infrastructure, and public health messaging to make it so intuitive as a regular practice.”
“We don’t appreciate what a miracle our sanitation infrastructure is. Without it, we would live in a much smellier, dirtier, and more contaminated environment.”
Matthew Freeman, PhD
Invisible Hazards
While the bathroom showcases some of the greatest achievements in public health through water and sanitation, it also carries hidden health hazards.
One of those is mold. When you take a hot, steamy bath or shower, the humidity in your bathroom increases, especially if the bathroom does not have good ventilation. That moisture creates the perfect environment for mold to grow—and when it does, it can cause respiratory symptoms, eye irritation, and rashes.
Making sure to turn on a ventilation fan or crack a window when showering is a great first line of defense against moisture and mold. Using a dehumidifier, cleaning frequently, and fixing leaks quickly can also help.
Another potential health risk may be lurking in your bathroom vanity.
Lotions, makeups, and hair-care products often contain man-made chemicals to enhance their effects. Sunscreens use oxybenzone to block UV rays. Waterproof mascaras achieve their tear-proof status with per- and polyfluoroalkyl substances (PFAS), also known as forever chemicals. Phthalates let the fragrance of your shampoo linger in your hair all day.
But evidence is mounting that shows these compounds can have serious health effects.
“These are endocrine-disrupting chemicals, and they can have reproductive effects, including risks to fertility,” says Carmen Marsit, PhD, executive associate dean for faculty affairs and research strategy. “Fertility rates are decreasing around the world, and that is partly related to exposure to chemicals like phthalates and PFAS.”
Rollins research has also revealed potential health effects for pregnant women and their babies. Exposure to phthalates during pregnancy has been linked to changes in metabolism and brain development after a baby is born. Other chemicals frequently found in personal care products can lead to high blood pressure during pregnancy, preterm birth, and other serious maternal health complications.
The Kitchen
Safe Food, Farm to Fork
Some say that the kitchen is the heart of the home. In it, we cook to nourish our families, gather with loved ones, and create memories. The kitchen can also be the epicenter of public health.
Food safety is critical to avoiding foodborne illness, and it begins before your vegetables, milk, or bread ever enter your house.
“When you bring food into your home, it's almost like welcoming a guest. And before walking through your door, that food has had a whole life,” says Juan Leon, PhD, associate professor of global health.
Throughout a vegetable’s life, for example, there are many moments when it can be exposed to contamination. A vegetable is planted in the soil, and as it grows, it can encounter different chemicals and microbes in the soil, water, and applications of pesticides or fertilizer. Once fully grown, someone (or, more frequently in the U.S., some machine) picks that vegetable. Then, it gets sent to the grocery store, where we buy it and bring it home.
Every step of the way, there is potential for contamination, but there are also regulations and interventions to avoid it. The Food Safety Modernization Act, passed in 2011, is one of them. It shifted the country’s approach to foodborne illness from response to prevention, setting standards for safe food production and distribution.
Food processing also plays a large role in reducing foodborne illness. In pasteurization, for example, dairy is heated up to a certain temperature and then held at that temperature for long enough to kill germs. Unpasteurized, or raw, milk has caused hundreds of foodborne illness outbreaks since the late ‘90s. And while pasteurization is vital to safely consume dairy products, it also creates an opportunity for chemical exposure.
“Milk has to get from the cow to the processing facility to be pasteurized, and it comes through plastic piping. Those plastic pipes could contain phthalates, or phenols, or other chemicals that could leach into the milk,” says Marsit. “But that does not mean that we should stop pasteurizing dairy; it just means that we always have to evaluate the risks and benefits of food processing.”
Once food leaves the grocery store shelf, safety is up to whoever buys it. This opens new possibilities for contamination and illness.
“The majority of food contamination happens at the handling and preparation stage,” says Leon. “When you go to a restaurant, there are a lot of people very quickly handling food, and they might not have been well-trained in safe food handling. Similar things also happen when we are preparing food at home.”
Leon emphasizes that food safety is a spectrum, and there can never be zero risk. But there are things that everyone can do when preparing food at home to keep themselves and their families as safe as possible: washing hands often, washing fresh produce (and not raw poultry, which can further spread germs), cooking food to the right temperature to kill germs, and keeping cold foods refrigerated.
“Milk has to get from the cow to the processing facility to be pasteurized, and it comes through plastic piping. Those plastic pipes could contain...chemicals that could leach into the milk. But that does not mean that we should stop pasteurizing dairy; it just means that we always have to evaluate the risks and benefits of food processing.”
Carmen Marsit, PhD
Caution When Cooking and Cleaning
Millions of Americans do their cooking on natural gas stoves, but research in recent years has found that they may be affecting our health. That is due to the by-products these stoves emit during cooking.
“From an air quality perspective, cooking is one of the most significant sources of indoor air pollution in homes,” says Longxiang Li, ScD, assistant professor of environmental health.
Methane, nitrogen dioxide, and benzene can all filter into the air from gas stoves, and all can cause health effects. Nitrogen dioxide, in particular, is linked to respiratory symptoms including coughing, wheezing, and difficulty breathing. It can also contribute to developing asthma. Some research suggests that over 10% of U.S. childhood asthma cases are tied to gas stove use.
Luckily, there is a solution that does not involve swapping out your gas stove for an electric alternative.
“Ventilation is the only solution,” says Li. “In America, a lot of stoves have fume hoods that are only internal ventilation—they pull the gas up, but then they send it back into the room rather than outside. That is not healthy.”
Gas stove emissions are not the only thing in the kitchen that could cause respiratory problems.
In recent years, common household cleaning products have undergone a shift, more frequently including disinfectants in their formulas. These disinfectants are typically quaternary ammonium compounds (QACs).
“My team looked at residential homes to study the occurrence of QACs in indoor dust, which gives us a good idea of indoor exposures,” says Amina Salamova, PhD, associate professor of environmental health. “We found that these chemicals are widespread and are in almost every home. The levels also increased significantly after the outbreak of COVID, when more people were disinfecting their homes more often. That tells us that the exposure is most likely from disinfecting.”
QACs can exacerbate asthma and other respiratory symptoms, and have been linked to skin irritation, inflammation, reproductive effects, and more. And they are not only a problem in homes. Salamova found that levels of QACs are even higher in daycares and assisted living facilities, and residents and staff in those are exposed to higher-than-average amounts.
Salamova suggests that those concerned about QACs have a few routes to limit their exposure.
“If it's just a regular day, you might not need to disinfect your space, and cleaning with just soap and warm water is fine,” she says. “You can also use safer alternatives for disinfecting. Instead of QACs, there are options like isopropyl alcohol, citric acid, hydrogen peroxide, or bleach. These days, it can be hard to find products using those alternatives in stores, but if you pay attention to ingredient labels, you can find them.”
No matter what you use to clean, it is always important to make sure you have good ventilation in the room by opening windows or running a fan.
The Living Room
Fans and windows help circulate air through your living room and ventilate the space, and are especially important if you are using cleaning products or burning logs in your fireplace. Carbon monoxide detectors also help keep you safe if the dangerous gas enters your home in high levels through a fireplace, stove, or furnace. Regulations about furniture's flammability help protect you during a house fire.
Ventilation, Mitigation
Gas stoves, fireplaces, cleaning products, mold, and even pets can put pollutants into the air, making air quality inside houses worse.
“Indoor air quality is even more important than outside air quality, because we spend so much time indoors,” says Li. “From the federal level, indoor air is not strictly regulated, because it is so hard to regulate. You can push homeowners to pay attention, but you can’t force anything, because it is private property.”
Li believes that it is especially crucial for homeowners to pay attention to radon. Radon is an invisible, odorless gas released by rocks and soil that can enter homes through cracks in the foundation. Exposure to radon is the second leading cause of lung cancer deaths, after smoking, in the U.S.
Radon exists all over the country, and radon concentration maps can help homeowners learn about the risk of high radon levels in their homes. Testing for radon is the only way to know a home’s radon level for sure. If a house does have a high concentration, there are cost-effective ways to mitigate the effects.
“Radon decays in three and a half days. That means that, if it can get into a home in three and a half days, it can impact human beings. But if it cannot, it will stay underground forever,” says Li. “That also means that the most effective way to mitigate radon problems is before the construction, when a membrane can be laid under the house’s foundation to stop radon from entering through the soil. This is now done in most new construction in areas with high levels of radon."
For older houses with high radon levels, the most effective mitigation strategy is to work with a professional to seal cracks in the foundation and install a system that vents radon outside from beneath the house. All homeowners can reduce radon levels by sealing cracks in their floors and walls and ensuring good home ventilation by using fans and opening windows.
“Indoor air quality is even more important than outside air quality, because we spend so much time indoors...You can push homeowners to pay attention, but you can’t force anything, because it is private property.”
Longxiang Li, ScD
Going Smoke Free
Another common source of indoor air pollution is cigarette smoke. Smoking is the number one preventable cause of death and disease in the U.S., leading to diseases that affect almost every system in the body, not just the lungs. Secondhand smoke can have equally disastrous health effects.
Breathing in secondhand smoke can cause heart disease and stroke in adults. It has been linked to asthma, ear infections, and sudden infant death syndrome in children. Exposure to secondhand smoke increases the risk of lung cancer by over 20%, even if the person exposed has never smoked before.
“With smoking regulations, almost all environments are smoke-free now. That means that the one place that's left where people can still smoke inside and expose others to secondhand smoke is in the home,” says Michelle Kegler, DrPH, director of the Emory Prevention Research Center. “This is particularly concerning for children, because they're captive in the home. If their parents or caregivers are smoking, they can't escape it.”
As with radon and other indoor air pollutants, secondhand smoke in the home is difficult to regulate. In 2018, the U.S. Department of Housing and Urban Development mandated that all public housing complexes implement smoke-free policies, and many private apartment complexes also have smoking bans. For private residences that are harder to regulate, public health fills the gap.
“Public health provides technical assistance, model policies, and tries to shift social norms so that multi-unit housing is smoke-free,” says Kegler. “Public health also provides assistance for smoking cessation. As smoking rates have gone down, there are naturally more smoke-free homes. But still, many people who smoke do not have a smoke-free home.”
The Smoke-Free Homes Project
Rollins School of Public Health is taking action to help create more smoke-free homes across the U.S. and abroad.
The Smoke-Free Homes Project, led by Kegler and the Emory Prevention Research Center, helps households create smoke-free home rules to protect families from the harmful effects of secondhand smoke.
Program participants receive three mailings and one coaching call over a six-week period. Some of the educational materials they receive include a smoke-free home tool kit, a five-step guide to creating a smoke-free home, and a photo novella.
When Kegler and her team tested the program in a randomized control trial, they found incredibly positive results: Participants were much more likely than people not participating in the program to have a full ban on smoking in the home.
“We kept this intervention easy so that it would be scalable and could be adapted to different environments,” says Kegler. “Now, we are adapting the program to see if it works in different populations, including tribal communities in the U.S. and communities in Armenia and the country of Georgia.”
The intervention is listed as a National Cancer Institute evidence-based cancer control program.
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Rollins Magazine is published twice a year by the Rollins School of Public Health, a component of the Woodruff Health Sciences Center of Emory University, for alumni and friends of the school.