Public toilets in parklands or open spaces in international cities using geographic information systems

Introduction and hypothesis: Availability of public toilets in parklands and open spaces is a community resource for all persons and may support self-management of incontinence. The purpose of this study was to describe and map the availability of public toilets in parklands and open spaces in major international cities by city population and area. Methods: Observational/descriptive design. Twelve cities in nine countries with available data about toilets in parklands (Minneapolis-St. Paul (MSP), New York City, Philadelphia, Toronto, and Osaka) or open spaces (Greater London, Greater Sydney, Paris, Berlin, Brussels, and Seoul) were included in the analysis. Data were from online open/free data sets. Availability of publicly owned and/or operated permanent toilet facilities was measured/analyzed as number, density (calculated by population and area (km²)), and distribution (visualized using Geographic Information Systems). Results: Density of public toilets/area (km²) in parklands was highest in Osaka. MSP had the most toilets per 100,000 residents. In open spaces, the density of public toilets/area (km²) was highest in Paris. Sydney had the most toilets in open spaces per 100,000 residents. The distribution of public toilets across parklands was fairly even in MSP, Philadelphia, and Toronto. The distribution of public toilets in open spaces was highly concentrated in one area in Brussels. Sydney has a low population density but a high toilet density in open spaces. Conclusions: Availability of public toilets in parklands or open spaces varies among international cities. Toilet availability should be considered in urban planning and community healthcare programs to promote continence, health, and quality of life.