Public bathrooms are a critical yet underexamined component of urban health infrastructure in the United States. Despite their importance for hygiene, dignity, and social participation, their availability and quality remain poorly documented. As public bathroom availability declines, private bathrooms like those in businesses are increasingly serving as de facto “public” options, raising questions about equity and accessibility. This study examined the availability, accessibility, and characteristics of traditional (government funded) and de facto public bathrooms (privately funded) in Atlanta, Georgia. We conducted systematic audits of bathrooms across 15 areas in Atlanta. Women’s, men’s, gender-neutral, and family/caregiving bathrooms were assessed using 32 location- and 86 bathroom-specific criteria. Descriptive statistics were calculated to summarize characteristics and density of bathrooms per square kilometer. Regression models were used to compare characteristics of government-funded and privately funded facilities. Of 262 identified locations, 55.3% were inaccessible due to lack of a publicly accessible bathroom, locked doors, or being fully occupied for more than 10 minutes. Across 117 accessible locations, 207 bathrooms were audited; 58.9% of which were privately funded. Overall facility density was 18.2 per square kilometer, with wide variation (range: 2.55-76.4). Government-funded bathrooms had a larger quantity of functional toilets, urinals, and sinks, whereas privately funded facilities were more likely to be single-occupancy and allow use without first requiring access via gate or turnstile. Findings reveal spatial inequities in public bathroom access across Atlanta and a reliance on private infrastructure to meet public needs, underscoring uneven urban sanitation provisions as a feature of the city’s built environment.
Shackelford et al. (Wed,) studied this question.