As published at Bloomberg CityLab

At the height of the Covid-19 pandemic, it was nearly impossible to find an open public restroom. Many public lavatories across major US cities remain closed today. In New York City, a recent investigation found that the city’s parks offer a scant 16 comfort stations per 100,000 residents.

Most of us have experienced the challenge of finding a public restroom, but for many, restroom access isn’t just a matter of convenience — it’s a serious medical issue. As the respective CEOs of the Crohn’s & Colitis Foundation and the Celiac Disease Foundation, we hear far too many stories from patients with digestive disorders detailing the physical pain and extreme anxiety — not to mention traumatic accidents — they’ve experienced when restrooms aren’t readily available. Diseases and challenges like these, which can force patients to stay home in the absence of restroom options, are far more common than you might think.

Our inadequate public restroom infrastructure directly harms individual and public health. People suffer when they don’t have access to these facilities. It is truly a fundamental human need, and solutions are long overdue.

The most obvious fix is for local governments to build more public toilets, but lack of available real estate and limited funding means cities aren’t likely to go on bathroom-building sprees anytime soon. That’s why we’ve concluded that private businesses can offer the best path forward to rapidly address the need for more restrooms. Businesses are rooted in our neighborhoods, welcoming and interacting with large numbers of people every day. And restaurants, retailers, hotels and other enterprises already have the necessary assets — namely, toilets — to expand restroom access today.

We believe local establishments can positively impact their communities with a simple act of human kindness: opening their doors to those who need to use a restroom.

To be sure, policy makers also have a key role to play, by spurring the creation of more public restrooms and by creating incentives to encourage businesses to make theirs more widely available. In New York City, for example, council members have introduced important legislation to bolster the city’s inadequate public restroom infrastructure. But there are obvious constraints as to how many and how quickly new restrooms can be constructed. When considering timing, cost, efficiency and scale, it’s clear that the public sector needs to develop creative solutions for this longstanding challenge.

One approach not yet tried in the US would be for legislators to create financial incentives for all businesses to open their facilities to the public. Motivating the private sector to participate may ultimately prove to be the most cost-effective and quickest option for giving the public increased access to toilets.

This concept is already in place in some German and British cities. Nette Toilette (“Nice Toilet”) launched in Germany in 2000, and the Community Toilet Scheme (CTS) launched in the London borough of Richmond upon Thames in 2004; both program provide payments to businesses when they voluntarily open their facilities to the public. Businesses in busy areas like commercial districts or those with fully accessible facilities (e.g., for families and people with disabilities) are specifically recruited.

Although the payment criteria and amounts vary across communities, these programs have proven to be a success: Richmond continues to operate its CTS, and additional boroughs in London have already implemented or are developing their own schemes. Meanwhile, more than 200 German municipalities participate in Nette Toilette.

Other options also exist: As a novel alternative to direct payments, governments could offer tax credits to encourage bathroom sharing. When businesses report that they have publicly available restrooms via their tax returns, they could be eligible for a tax rebate proportional to the size of their revenues, the population of the city, or the number of open stalls they offer. Federal and state tax incentives already exist to encourage compliance with the Americans with Disabilities Act — we believe that governments can similarly motivate businesses to improve public restroom access.

In all these examples, participating businesses could promote the availability of their facilities through stickers on their windows and participation in local maps. They could also be spotlighted in local marketing campaigns. And business participation could be promoted and monitored at the same time: Just add a requirement that businesses join a participating restroom-finder app, such as the Crohn’s & Colitis Foundation’s We Can’t Wait app. With this, the government could easily cross-check tax statements to ensure that businesses are truly making their restrooms available.

Learn more about the Open Restrooms Movement here.