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They are indispensable for life, but there is rarely a dialogue around public toilets. Invisible and at the same time crucial, access to a toilet can determine how we live our lives, especially for people who depend on this infrastructure for a medical condition.
We can all feel identified with a need as basic as wanting to use a bathroom in a public space and not being able to access it. Many times, the toilets available are only those of private establishments such as bars and restaurants and free access is not always allowed. That difficulty and discomfort, which for many is anecdotal, is for others a daily condemnation.
There are several people who can be described as “public toilet dependents”. This is what a group of Spanish scientists from the Camilo José Cela University have done: they are patients with intestinal inflammation diseases, such as colitis or Crohn’s disease, but also those who have a urinary condition. Even people who constantly take medication that is highly diuretic.
According to research by Guido Corradi, a professor at the university and author of several studies on the use of public toilets, not being able to access public toilets easily has an effect on the quality of life of these people. An impact of up to 10% less than people who do not depend on these infrastructures. In an interview with France 24, Corradi gives an example: “That you have to change your plans, for example, because you know there is no bathroom.”
“There are people who told me, ‘I don’t go to the park, the doctor tells me to exercise and go for a walk, but I can’t because the green area next to my house doesn’t have bathrooms,'” explains the researcher.
Not having accessible and available toilets also has an impact on health. First, because it increases the shame felt by those who are dependent on the toilets regarding their illnesses or conditions. This makes them “less capable of asking for help and looking for it in other people,” recalls Corradi, something that in the medium and long term can worsen the condition.
But also, it has been shown that not using the bathroom when needed damages our own organs… and not just that of people with a disease.
We all depend on a public toilet
“Everyone is going to be dependent on a public bathroom at some point,” says Corradi. It is enough to have a punctual gastroenteritis, or to be in a moment of abundant flow of the period. It is also enough to be an older adult, a boy or girl, or a pregnant person to need to go to a toilet more frequently than we consider usual.
According to research carried out by various departments of Urology in the United States and published in 2020 in ‘The Journal of Urology‘, people who can’t wait to use the bathroom later have more symptoms of urinary tract infection. The study was conducted particularly in women, a population disproportionately affected by the lack of access to public toilets.
Women who reported limiting their use of toilets during the day reported four percentage points more urinary incontinence than women who did not limit their use. In the case of overactive bladder, which is characterized by having an uncontrollable urge to urinate suddenly, 32% of women who tried to avoid the bathroom reported suffering from it, while 25% of the other group reported it. Infections were also more recurrent: 7.2% versus 4.7%.
What happens with women happens with any population that sees their use of the bathroom restricted. For example, any profession that makes it difficult to find time, such as medical professionals. The most precarious jobs, in fact, tend to have worse facilities, or less accessible, jobs that also tend to be more feminized, such as supermarket cashiers.
“Part of the problem is that a lower socioeconomic status is related to jobs that are much more demanding on a day-to-day basis, in which you do not work in your own office but in a shared space, or where you do not have access (to a bathroom) Corradi explains. In addition, he emphasizes that these people “usually live further from their job, which is a key point, because it takes more time in a transport” and they move “in places where there will be less quality of these bathrooms.”
Of course, it also disproportionately affects trans, non-binary, and traditionally gender nonconforming people, whose access to public restrooms is often inconvenient if not policed or even regulated by authorities.
What is the ideal bathroom?
The solution to these problems is not difficult: improve the infrastructure of public toilets. However, being a “taboo” subject, as Corradi describes it, it does not usually gain much attention or generate much debate despite the fact that it is “much more entrenched in us than we thought”.
In order to have a useful infrastructure, Corradi reminds us that there is no single answer, since different groups tend to need different things (a clear example is the long lines in the women’s toilets compared to the short waits suffered by men). However, according to another investigation of your teamthere are three axes that always stand out.
The first is privacy, something as simple as whether the bathroom has a security latch or not. The second is hygiene, something that greatly determines the quality of the bathroom and can even decide, for people who have that option, whether to use it or not. The last one is precisely usability: do you have toilet paper? Do you have trash? Do you have a hanger where to put the jacket?
For Corradi it is clear: “Any improvement for a vulnerable group necessarily reverts to improvements for the normotypical group.”
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