Pacific beach restrooms and hours of operation.

Access to basic sanitation is a human right and a critical environmental determinant of health. In this paper, we detail the development of three tools to investigate sanitation justice: (1) our public restroom spatial database, (2) our field assessment tool, and (3) survey of restroom access experiences. We document our process to collect these data in a consistent, health equity-driven framework. Together, these tools comprise a suite of methods for the examination of public restrooms from the macro- to the micro-level, and highlight key opportunities to promote health and well-being among restroom-reliant populations (e.g., people experiencing homelessness) by advancing sanitation justice in the built environment. With an illustrative case study, we demonstrate how methods triangulation, using the tools in concert, can provide a comprehensive assessment of basic sanitation access in a given region–San Diego, CA. We also detail how each tool can also be used separately to assess key sanitation justice and health equity questions that may be of interest to researchers, public health practitioners, policymakers, and advocates, including: (1) where do public restrooms exist (mapping)?; (2) how accessible are public restroom facilities, and what health-supportive features do they have (field assessment)?; and (3) what are the experiences of people most reliant on the available public restroom facilities (survey)? The results of our case study demonstrate that these adaptable tools can be used to provide meaningful data on and a holistic picture of public restroom quantity, quality, accessibility, and the experiences of public restroom users in a given region.

基本卫生设施可及性是一项人权，亦是影响人类健康的关键环境决定因子。本研究详述了三款用于探究卫生正义的工具的开发流程：(1) 公共卫生间空间数据库、(2) 实地评估工具，以及(3) 卫生间使用可及性体验调查问卷。我们采用以健康公平为导向的统一框架，记录了上述三类数据的采集过程。上述三款工具共同构成了一套可从宏观至微观层面开展公共卫生间研究的方法体系，并凸显了通过优化建成环境中的卫生正义，以提升依赖公共卫生间人群（如无家可归者）的健康与福祉的关键可行路径。通过一则示范性案例研究，我们展示了协同使用这些工具开展方法三角验证，可如何对特定区域——美国加利福尼亚州圣地亚哥市——的基本卫生设施可及性进行全面评估。此外，我们还详述了各工具亦可独立使用，以解答研究者、公共卫生从业者、政策制定者及维权倡导者可能关注的核心卫生正义与健康公平相关问题，包括：(1) 公共卫生间的空间分布情况（测绘分析）；(2) 公共卫生间设施的可及性水平及其具备的健康支持性特征（实地评估）；(3) 高度依赖现有公共卫生间设施人群的使用体验（问卷调查）。本案例研究的结果表明，这些具备灵活性的工具可用于获取特定区域内公共卫生间的数量、质量、可及性以及使用者体验等方面的有效数据，并构建起相关议题的完整图景。