Newsletter #50: 🏡 Place as medicine: How our homes can create health or disease

Friends! I am so excited to introduce one of my dear friends of 20 years, Carrie Denning Jackson, as the guest author of the newsletter this week.

Carrie is leading groundbreaking work at the intersection of health and the built environment. Formerly working with Google and IBM on smarter city design, she is now the founder of Place As Medicine and is the Director of Innovation at Jamestown LP, a global real estate firm. In the article below, she breaks down how our homes and buildings can either contribute to illness or support healing.

In Good Energy, I explore how key factors—food, sleep, movement, stress, microbiome, light exposure, thermal environment, and toxin load—shape our cellular function and, ultimately, the quality of our lives. But one critical factor often goes overlooked: the way our spaces are designed. Everything from layout and materials to furnishings directly influences all these levers, affecting our sleep, Circadian rhythms, toxin exposure, microbiome contents, stress levels, and even susceptibility to infections.

Carrie shows us that just as we know food is medicine, PLACE can be medicine too. I’m so excited to share her powerful, actionable overview below. 👇️

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🏡 Place as medicine: How our homes can make us sick, or help us thrive

By Carrie Denning Jackson

Six in ten Americans have at least one chronic disease. 40.5% of men and women will develop cancer in their lifetime in the United States - a mind numbing number. Recent calls to action to mitigate these trends have focused on increasing access to drugs, improving school lunches, banning known cancer-causing chemicals in food, and the Surgeon General’s call to consider a health label on alcohol.

And yet, when we talk about chronic disease in America, we’re missing a BIG part of the picture. What we virtually never talk about is the impact of the physical spaces where we spend time and how these places can help or hurt our health. Just as we consider FOOD as medicine, we need to think about the PLACES we live as medicine, too. We spend 90% of our lives indoors (!), and research is becoming increasingly clear that the materials used in our indoor spaces directly impact our health and disease risk.

This is true especially for me. Despite a 15+ year career in innovative building projects, including Google’s effort in Toronto to build the smartest, most innovative city in history, I never encountered a SINGLE conversation around the impact of building materials on our health. 🤯

This entire field only became a priority for me when I was pregnant and looking for furniture for my soon-to-be son’s room. I assumed it would be a painless process. And yet, scrolling for cribs, it was impossible to discern marketing from science. Websites had vague terms like “eco-engineered” and endless lists of certificates. One website advertised their “non toxic” crib, but even there I was lost. What about a crib could be toxic? If they were touting a non-toxic alternative, what about all the unknowing parents buying toxic cribs?

The more I read, the more I realized that the scope of this challenge is vast. According to the Environmental Protection Agency (EPA), 72% of the environmental toxins we encounter are found in our homes. Between the moment you wake up and when you make your morning coffee, you may have already encountered formaldehyde in your furniture, flame retardants on your couch, and endocrine-disrupting phthalates in your vinyl flooring – all modern man made chemicals from the past 2 centuries.

Children are especially at risk because their bodies are still growing, and they often play on the floor and furniture, where chemicals like phthalates, phenols, flame retardants, and polyfluorinated alkyl substances (PFASs) may be present. According to a 2016 study, “Exposure to one or more of these chemical classes has been associated with adverse health effects including reproductive toxicity, endocrine disruption, cognitive and behavioral impairment in children, cancer, asthma, immune dysfunction, and chronic disease.”

And, our buildings don’t just strongly impact risk for non-communicable diseases like depression, anxiety, diabetes, heart disease, cancer, asthma, respiratory illnesses, dementia, and more, but they also can impact how infectious disease spreads. We’ve even discovered that building choices like wall and flooring materials, ventilation, and even air moisture levels all have an impact on the transmission potential of pathogens indoors.

🔁 There are great, healthy, affordable alternatives

There are many elements to consider when designing with health in mind, and it’s overwhelming even knowing where to begin. Back when I was researching cribs, and even now, I feel frustrated that the burden of responsibility to protect myself and my family falls on me, with industry getting by with minimal regulation.

The good news, however, is that there are many healthy alternatives.

A few examples to make the point:

🪵 Vinyl Flooring vs. Cork or Linoleum: Polyvinyl chloride (PVC), commonly known as vinyl, is made using dioxin, the “the most toxic man-made substance ever” according to Parsons’ Healthy Materials Lab. The areas of the world where vinyl is made are known as “Cancer Alley” and “Chemical Valley” respectively; the latter reports having fewer boys–not a huge surprise given the relationship between estrogen and phthalates, an ingredient used to make vinyl flexible. 🤯 Natural solutions like cork or linoleum (made from linseed oil, wood flour, cork dust, and natural resins) do not carry these health risks. Cork, in fact, is naturally antimicrobial and resistant to mold, mildew, and pests.
🖌️ Acrylic-Based Paint vs. Mineral Paint: Even when branded as having no- or low-volatile organic compounds (VOCs), acrylic-based paints can still contain toxic chemicals in their additives and solvents. For instance, Alkylphenol ethoxylates (APEs), used in acrylic paint to improve pigment dispersion, are endocrine disruptors. Moreover, paint contributes up to 58% of all microplastics in the ocean—more than plastic bags, bottles, and straws combined. Mineral paint is a far better option. It is visually stunning, does not offgas, and is naturally mold and mildew resistant. Alkemis paint and Keim’s Innostar line are good options.
🏠️ Drywall vs. Shikkui: Conventional drywall is non-renewable, can cause mold growth, and some versions can contain mercury. Shikkui, a traditional Japanese plaster made with lime, is a natural, fully compostable product that’s antiseptic, humidity-regulating, mold- and fire-resistant, and actually absorbs CO2 and VOCs, which improves air quality.
🛋️ Conventional vs. Healthy Couches: Conventional versions can contain flame retardants in the foam, formaldehyde in the wood, and polyfluoroalkyl substances (PFAS, or “forever chemicals”) in their “performance fabrics.” Healthier versions made with natural latex, wool, solid wood frames, and cotton, jute, hemp fabrics avoid these toxic chemicals. Cisco Home and Medley are great options.

…The list goes on!

🎨 We can choose to design our spaces for health

There are innumerable aspects of our built environments that impact core cellular biology, which are currently overlooked in nearly all building planning. Below are a set of just a few considerations that would impact human health if consistently incorporated into our built environments:

🏗️ Non-toxic materials & indoor air quality: Using low-emitting, non-toxic building products (e.g., mineral paint vs. zero or even low-VOC paints, formaldehyde‑free materials); eliminating synthetic scents in buildings (e.g., scented soaps, detergents, “air fresheners,” laundry sheets, trashbags, cleaning products, etc); reducing plastics (like polyester and other plastic-based sheets, couches, artificial turfs, storage containers, and carpets); and avoiding indoor insecticides (i.e., Raid). Choosing non-toxic materials when thinking about paint, finishes, furniture, upholstery, flooring, insulation, and building materials.
🪟 Effective ventilation & filtration: Ensuring robust air exchange, high-quality filters, and opening windows periodically to reduce particulate and VOC buildup, support a balanced indoor microbiome, reduce pathogen exposure, and regulate moisture.
💧 Moisture & mold control: Using proper, non-toxic insulation and dehumidification to prevent dampness, mold growth, and “sick building syndrome.”
🍃 Easy access to the outdoors: Ensuring that buildings are designed with multiple entry points and pathways that provide uncomplicated access to outdoor spaces, encouraging physical activity, exposure to natural light, and connection with nature for improved well-being.
🦠 Support for a healthy indoor microbiome: Encouraging natural microbial diversity via thoughtful ventilation, surface materials, and moisture.
🚰 Advanced water management: Installing, testing, and maintaining full-home or full-building filtration systems to avoid contaminants like heavy metals, PFAS, and waterborne pathogens.
🧯 Fire safety without harmful additives: Using naturally fire-resistant materials that meet safety standards.
☀️ Natural & circadian lighting: Maximizing daylight and employing adjustable lighting systems to support melatonin production and Circadian biology. The way our spaces are designed can encourage us to spend more time outdoors (i.e., outdoor walkways between rooms) versus being cooped up inside.
🔉 Acoustic design: Incorporating non-toxic sound-absorbing materials to reduce noise-induced cortisol spikes and inflammation.
🪴 Biophilic elements: Integrating copious indoor greenery and other natural elements (e.g., woodgrain, natural scents like Hinoki cypress, water features) to lower stress hormones.
🛋️ Spaces to be together: Creating communal areas that foster social interaction and lower stress, supporting overall mental health.
🤸 Spaces to move: Planning accessible spaces that encourage movement, physical activity, and reduce repetitive strain. Good building design can be a forcing function to move rather than be sedentary.
🌬️ Radon: Implementing measures for the detection and mitigation of radioactive radon gas in buildings to ensure safe indoor air quality and reduce risks associated with long-term exposure.
📶 EMFs: Assessing and managing electromagnetic fields (EMFs) to minimize potential health risks, using timers for WiFi, and incorporating shielding techniques and safe distances from high-EMF sources in building design.
👷 Life cycle material assessment: Evaluating materials for long-term environmental and health impacts from production to disposal; it’s not just about the health of the end-occupant, but manufacturer, installer, etc.

But if our buildings are making us sick, and we have alternative options, what’s going on? 🤔

1️⃣ First, very few people are talking about this.

Only a handful of architecture schools have a class on healthy building materials. Likewise, the relationship between our homes and our health is not part of the standard medical school curriculum. And, while the EPA’s Toxic Substances Control Act (TSCA) exists to regulate chemicals, unlike the FDA, it does not mandate that companies put ingredient lists or nutrition facts on the side of paint cans or couches. And yet, we are ingesting, absorbing, and breathing in toxic chemicals every day.

To my mind, no one should be able to work in the building sector–construction, architecture, interiors–without understanding how their decisions could hurt or harm someone’s health. At Harvard and MIT’s architecture programs - two of the very best - an informal poll showed that only 16% of the class enrolled in a healthy buildings course. One graduate recently said to me, “This is the #1 architecture school in the country. We shouldn't be designing for sickness.” It is reminiscent of the statistic that less than 20% of medical schools require a single nutrition course.

Likewise, doctors–notably pediatricians and obstetricians–should have some knowledge of how our homes can affect our health. If asthma is an issue, hand out a pamphlet with non-toxic cleaning products, prescribe an air filter, or tell someone it’s ok to open a window, as indoor air can be 2-5x worse than outdoor! Are doctors aware that as much as 40% of the excess asthma risk in some populations is attributable to indoor air pollutants? For an expectant mother, guide her towards furniture and paint options for nurseries that minimize health risks. There are healthy options at many price points.

2️⃣ Secondly, we need to adopt chemical regulations similar to those implemented in Europe.

The European Union's law on the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) requires manufacturers to prove their chemicals are safe before use. In the US, the EPA’s TSCA must prove a chemical is unsafe. This is backwards! And while recent reforms have strengthened evaluation requirements, there are still 86,000 chemicals in use. We have tested 1% and banned only a handful. At the very least, consumers need a basic ingredient list in order to make informed decisions.

3️⃣ It’s important to remember that advocacy works.

About 10 years ago, leading advocacy groups pushed sellers like Home Depot, Lowe’s, and Lumber Liquidators to remove endocrine-disrupting phthalates from vinyl flooring (though be mindful - you can still buy vinyl flooring with phthalates). Ikea, one of the leaders in the healthy materials space, no longer adds any formaldehyde to their products. This type of work is happening and can keep happening.

💡 **Small-ish steps you can take today:**

(Note: Most of this you can do regardless of renting or owning)

🌬️ Air Quality: Install and maintain HEPA air purifiers, open your windows regularly, run your fans if using a gas stove (switching to electric or induction is much better), look at humidity levels (too high = mold, too low = potential respiratory issues), ideally, and if budget allows, find someone to evaluate your HVAC; opt for non-scented cleaning supplies with minimal to no toxic chemicals; if concerned, test for mold.
💧 Water Quality: Test your water and look into water filters, ideally for the full home, but at minimum your sink. If this isn’t possible, look at your water quality on the Environmental Working Group’s tapwater database. Filter water with a high quality reverse osmosis filter.
- 👋 Note from Casey: My husband and I use a water filtration system from Beyond O2 water (which I have no relationship with) which uses a five step water filtering system including carbon, coconut carbon and reverse osmosis.
😴 Sleep: You spend a third of your life in bed; if budget allows, get an organic cotton, wool, or latex (made from rubber trees) mattress and set of pillows (Avocado is an reasonably affordable organic brand).
💡 Lighting: Bad lighting can wreak havoc on your metabolism. The easiest fix is to install dimmers, which an electrician can do quickly and easily. If you want to do more, you can upgrade to tunable white light, full spectrum white light, or even color depending on budget. Recommend ~3,000 Kelvins (warm white), low flicker and diffusers to avoid glare and headaches, and a Color Rendering Index above 87 for accurate color and information retention.
🛋️ Upholstery, Rugs, Fabrics: Ask yourself: Would my grandma know this material? An exception is TENCEL or Lycocell - just a fancy way to say it’s wood pulp. Look at your couches, chairs, rugs, and fabrics like towels and even your clothes. Go organic to avoid heavy pesticides, notably on cotton.
- 🙅‍♀️ Avoid: Fabrics such as polyester, nylon, acrylic, and similar materials. Also, be cautious of stain-resistant or "performance fabrics” as these can be coated with PFAS. Do not purchase anything coated in flame retardants.
🪑 Furniture: Choose metals or solid wood for your furniture whenever possible. Look for items that use non-toxic adhesives and stains, and allow new furniture to off-gas outdoors or with windows open.
- 🙅‍♀️ Avoid: Furniture with labels such as engineered wood, composite wood, pressed wood, fiberboard, MDF (Medium Density Fiberboard), chipboard, man-made wood, or synthetic wood, as these materials often contain high levels of formaldehyde (note: formaldehyde does naturally occur in wood).
🎨 Paint: It's better to opt for non-acrylic-based paints. If you choose something like mineral paint, the good news is that it will trap the toxic VOCs from the previous coat, preventing any further off-gassing.
🪴 Biophilia: Buy plants, get natural light, bring in wood elements, try organic essential oils, get outside and be in nature as much as possible.
📶 Reduce EMF Exposure: Use timers for WiFi routers to turn them off at night, keep electronic devices away from sleeping areas, and use wired internet connections where possible to minimize exposure to electromagnetic fields.
👟 Take your shoes off when you come home :-)

🏡 Examples of healthy homes and spaces around the world

1. Schiller Architect’s Brooklyn Mass Timber House is a sustainably repurposed historic carriage house that uses mass timber—a renewable, strong, and fire-resistant wood material—combined with passive house principles that ensures healthy ventilation and energy efficiency along with biophilic design for connectivity to nature and recycled original building materials.

2. PA Hemp Home is a pilot project in New Castle, PA, by DON Enterprise along with the Parsons Healthy Materials Lab, utilizing HempLime insulation for a sustainable and healthy renovation of an affordable home to achieve energy efficiency, healthy ventilation, and enhanced indoor air quality, serving as a model for future healthy, affordable housing initiatives nationwide. The project was an Honoree of the 2021 Fast Company Design Awards.

3. A home in Japan made with Shikkui, a traditional Japanese plaster made with lime, is a natural, fully compostable product that’s antiseptic, humidity-regulating, mold- and fire-resistant, and actually absorbs CO2 and VOCs, which improves air quality.

📌 Resources for more healthy home learning:

Green Science Policy Institute and their Six Classes videos - Founded by Arlene Blum, a remarkable chemist and mountain climber. In the 1970s, she discovered that flame retardants in children's pajamas were carcinogenic and could cause several neurological and endocrine problems in children. She also led the first all-female expeditions up Denali and Annapurna. This website has a set of six videos called “Six Classes of Concerns” which walks through the problems with certain chemicals and alternatives; these include PFAS, antimicrobials, flame retardants, bisphenols and phthalates, some solvents, and certain materials.
Parsons Healthy Materials Lab - Alternative products; geared more towards architects, but helpful nonetheless; they also offer an online class to go deeper on healthy materials - highly recommend.
Habitable’s Informed Guidelines - Very much geared towards the building sector vs. consumer, but useful if you want to nerd out, know what to avoid, and get the latest on forward-thinking, positive change in the industry.

In short, we need to talk and continue to talk about the relationship between where we live, work, and study and our health. The places we spend our days can make us sick or help us get better. Just as food is medicine, place can be medicine, too. We just need to start talking about it!

With good energy 💓

Dr. Casey

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💃 About the author: Carrie Denning Jackson

Carrie Denning Jackson is the founder of Place as Medicine, an organization dedicated to creating healthy environments. She also serves as the Director of Innovation at Jamestown LP, a global real estate firm. In this role, she pilots and implements new ideas throughout the portfolio, including healthy materials and practices. Prior to joining Jamestown, Ms. Denning Jackson was a Director on the Development team at Sidewalk Labs, Google’s urban innovation company. She has worked at IBM Smarter Cities as well as the Environmental Defense Fund, as part of their Livable Cities team.

She is a board member of the New York Chapter of The Nature Conservancy, the Governors’ Island Foundation, PlanA Health, trubel&co, and an advisor to Georgia Tech’s Master of Science in Urban Analytics. Ms. Denning Jackson has a Bachelor of Arts, Master of Arts, and Master of Business Administration from Stanford University. She lives in New York City with her husband, son, and adopted black lab, Leroy.

Her mission through her work is to build healthy places and drive change. Follow her work on PlaceAsMedicine.com and @placeasmedicine on Instagram.

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