A livable city should have an adequate number of public toilets. Urban planners plan for public spaces, pedestrian access, good transit and parks, but they almost never plan for providing public toilets.
The issue comes up in debates about urban planning, if at all, when talking about homelessness. But it’s not just unhoused people who need places to go to the bathroom. Providing public toilets is a diversity issue, an old-age issue, a disability issue, a parents’ issue, a feminist issue, a public health issue and an economic development issue.
Most people don’t like talking about bathroom functions and the difficulties they might have with finding and using bathrooms. Mothers with young children, elderly people that need to go unpredictably and people with Crohn’s disease or other bowel or urinary disorders, as well as unhoused people, have the same difficulties.
Above all, providing public toilets is a health issue for all of us. Human excreta and the lack of adequate personal and domestic hygiene have been implicated in the transmission of many infectious diseases including cholera, typhoid, hepatitis, polio, cryptosporidiosis, ascariasis and schistosomiasis.
Some of the diseases that can be spread through the fecal-oral route include hepatitis A, hepatitis E, cholera, adenovirus and E. coli. These diseases occur due to the viruses, bacteria, fungi and parasites that can spread through fecal-oral transmission.
The San Diego region experienced a hepatitis A outbreak in 2017 that spread rapidly through its unhoused population. The outbreak was not fully contained for two years, and it sickened nearly 600 people and caused 20 deaths, sadly.
If you live on the streets of the city or county of Fresno you are at a greater risk of infection because of a dearth of public bathrooms.
If an unhoused person has to use the bathroom, it is difficult to find a toilet. Often, it’s in a coffee shop, a convenience store, a fast-food restaurant or in another private building—so it’s not a public toilet.
Since the Covid pandemic, many private businesses have barred everyone except customers from using bathrooms. That remains the case.
The city and county of Fresno have few public restrooms. Most are in parks, libraries and city and county buildings.
The United States has eight public toilets per 100,000 people. That number is comparable with the rate in Botswana and far behind Iceland’s world-leading 56 public toilets per 100,000.
The current lack of public restrooms in Fresno and the nation relates to many different issues, including public health, social services and many types of discrimination.
Public toilets have existed in the United States for many years. The expectation for privacy while going to the bathroom in a public space emerged in the 19th century, with the Industrial Revolution and modern plumbing.
In the 19th century and into the 20th century, sanitation became a greater priority. People began to understand sanitation’s role in containing outbreaks of waterborne diseases and cities built public toilets.
However, because of racism, homophobia and ignorance, bathrooms became segregated. Bathrooms were separated by gender, as they still frequently are.
Public toilets started closing as early as the 1930s, with the LGBTQ+ community as a target. Beginning in the 1930s and 1940s, public officials began to complain about “perversions.” They began to complain about same-sex sex in bathrooms.
In the first half of the 20th century, bathrooms often were segregated by race, with Black Americans, or Latinos in the Southwest, as the targets. By the 1960s and 1970s, public toilets requiring small payments sprang up, but those ended up closing after concerns about gender discrimination.
Other efforts to remove public toilets came in the 1980s as part of a broader push to drive unhoused people to the edges of cities by taking away their access to public spaces and aggressively enforcing public urination laws. Unfortunately, limited access to restrooms and sanitation has remained a practice and a policy in Fresno and throughout the country. And if you are unhoused, the nearest bathroom might be a one-mile walk.
Racial segregation in toilets might sound like distant history or a footnote, but that racism still exists.
In 2018, two Black men were blocked from using the restroom at a Starbucks location in Philadelphia’s Center City. The incident prompted Starbucks to take on a role as America’s de facto public toilets, as it changed policy to allow people to use the restrooms at more than 15,000 U.S. locations without buying anything.
But Starbucks seems to be changing its policy. Starbucks announced in July that it would close 16 stores due to safety concerns.
CEO Howard Schultz said in June that the coffee giant might restrict its currently public restrooms to customers only, as part of its broader push for store safety. If Starbucks makes this decision to no longer serve as America’s public restroom, where will people be able to go?
Even if a person isn’t homeless, bathroom access advocates say there are going to be fewer and fewer options for people to be able to relieve themselves and that this has become a public health issue.
In San Diego, the city acknowledged that a lack of public restrooms, especially for unhoused people, was part of the 2017 hepatitis A outbreak, and installing public toilets and hand-washing stations helped to contain it. Unfortunately, a lack of funding or upkeep quickly led to the toilets disappearing.
A report earlier this year from researchers at San Diego State University found many of the toilets closed after the start of the Covid-19 pandemic and that nearly half the county’s Census tracts, home to 40% of the population, had no public restrooms.
Other cities are moving ahead with plans to install new public toilet facilities, including Portland, Philadelphia and Washington, D.C. However, there’s still a shortage of public toilets in the United States and it’s pretty dire.
Fresno can install public toilets and hand-washing stations throughout the city. It’s the right thing to do because water and sanitation are human rights under international law.
In 2011, a UN independent expert, Catarina de Albuquerque, studied water and sanitation rights on a mission to the United States. Her report found an instance in Sacramento where public restroom closures and enforcement of public urination and defecation laws led to a homeless person traveling miles to dump a whole community’s human waste.
In the report, she indicated that the laws had a discriminatory effect and led to “a violation of human rights that may amount to cruel, inhumane or degrading treatment.”
The city and county of Fresno, by failing to provide the right to basic sanitation, are doing the same. What is even more troubling is that the City, the County and the Fresno-Madera Continuum of Care could pay for basic sanitation. They have received $230 million in funds over the past three years, yet nothing has been spent on providing basic sanitation.