When radiation gets into living cells, it’s like firing a cannon in a pottery store. It breaks and mangles anything it gets near, the worst place being the cell nucleus and the DNA stored there. This is why ingesting or inhaling radioactive material is very, very bad.
The geographic contamination part of your question is actually subtley different from that.
When radiation gets into places as fallout or as the result of some meltdown like at Chernobyl, the most dangerous form it can take is as dust in the air. This dust can get into your lungs and do the stuff I said in the first paragraph. The radiation isn’t actually making new dangerous material, it’s just covering everything in a toxic layer of dust.
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