Availability of Public Toilets in Parks and Recreational Sites in Major US Cities

Background: Approximately 25 million Americans are incontinent and accessing public toilets is an important self-care strategy. Availability of public toilets in parklands/recreational sites (i.e., park-public toilets) may promote continence and well-being.    

Purpose: To map and describe the availability of park-public toilets in 9 major US cities per their resident population.

Methods: Data of publicly owned and operated permanent toilet facilities from cities’ parks/recreation department were mapped using Geographic Information Systems. Number of toilets in Census tracts were divided by population and residential area (mi²) using US Census data. Cities were Austin, Minneapolis, Nashville, New York City (NYC), Philadelphia, St. Paul (STP), San Francisco (SFC), Seattle, and Tampa.

Results: The total number of park-public toilets was greatest in NYC (616) and lowest in Nashville (48). The most population-dense cities were NYC (27,953/mi²), SFC (17,991/mi²), and Philadelphia (11,560/mi²). Per 100,000 residents, Minneapolis and STP had 30 park-public toilets; Tampa, Seattle, Philadelphia had 17-22; and Nashville, NYC, SFC had ~7.  Park-public toilet availability/density was highest in Minneapolis, NYC, and Philadelphia with > 2/mi², followed by STP, Seattle, and SFC with 1/mi², then Tampa, Austin, and Nashville with <1/mi² when adjusted by residential area. The proportion of Census tracts containing park-public toilets was >0.4 in Minneapolis, Seattle, Tampa, STP, and Philadelphia, >0.20 in Nashville and Austin, and <0.20 in the other cities. Mapping of park-public toilets showed fairly even distribution across Census tracts in Minneapolis, Seattle, Tampa, STP, and Philadelphia.

Conclusions: Availability of public toilets in parks/recreational sites is best in Minneapolis. Among the three population-dense cities, geomapping showed park-public toilets in Philadelphia are more evenly distributed than in NYC or SFC. Findings inform continence/WOC nurses in counseling incontinent patients about coping/self-care strategies. Urban planning that provides an adequate number and distribution of park-public toilets may improve quality of life of incontinent individuals.