Should cities provide public restrooms? Should they be free or paid? Where should they be placed? What amenities should they include? Those were among the questions raised in an article in the August 1914 edition of The American City by Donald Armstrong, acting director of the Department of Social Welfare, New York Association for Improving the Condition of the Poor. “Public Comfort Stations: Their Economy and Sanitation” described a variety of restroom facilities cities had constructed to improve the sanitary conditions in public places and offered ideas for their management.

For instance, the New York Department of Public Works operated nine free comfort stations in Manhattan in 1912 and spent $52,000 annually on their operation. In Baltimore, one-third of the city's public restrooms charged a fee for use. Visitors paid five cents for a private compartment with toilet, washstand, soap and mirror. The fees covered a portion of the city's expenses in operating the facilities. Other cities made small profits from charging for use of public facilities, and some generated revenue from granting space to concessions, such as telephone booths, boot-black stands and parcel rooms.

The author noted a mistake that many cities made by neglecting to put public restrooms where they were most needed, which, at the time was in congested tenement sections and busy trucking centers. He suggested small, low-cost, low-maintenance facilities would meet the needs of the people in those areas and improve sanitary conditions.

To ensure the facilities help prevent the spread of germs, Armstrong suggested removing handles from doors and replacing them with locks that could be operated with a foot. He also reports the results of a survey in New York that found public restroom visitors were more likely to wash their hands if individual towels, hot and cold water, and mechanical soap dispensers were provided. “The wider extension of these provisions is to be urgently recommended to all American municipalities if the public decency as well as the public health is to be maintained,” he wrote.

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