Availability, accessibility, and functionality of public restrooms in the City of St. Louis, Missouri

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BACKGROUND: Individuals experiencing homelessness face daily challenges of sanitation and hygiene. These challenges are exacerbated during menstruation. AIM: We sought to assess the location, accessibility, and functionality of public restrooms in the City of St. Louis. METHODS: We compiled and mapped a list of public restrooms based on local government websites. Then, using an audit tool based on previous research and UNICEF guidelines, we audited them for accessibility, functionality, cleanliness, and infrastructure that facilitates menstrual hygiene. We also determined the service area for each public restroom by mapping a 0.5-, 1- and 2-mile travel distance along the road network around each restroom location. RESULTS: In total, we visited 31 unique locations and audited 53 restrooms. Four locations were completely boarded up and could not be audited. Only 15 % of the City's total area is within one-half mile of a public restroom, and 67 % is within 2 miles from the closest public restroom. Nearly all the audited restrooms had functional toilets and locks/latches on the door or stall for privacy. Only 10 of the restrooms had period products available, and less than half had disposable bins available within reach of the toilet. CONCLUSION: Availability of public restrooms is a key concern in St. Louis - limited both by physical availability and hours of operation. When restrooms are available, however, they tend to be physically accessible and functional, while infrastructure to help maintain menstrual hygiene is more limited. Local government needs to invest in increasing the availability of public restrooms for those in need.

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