There is no place to go in "America's Finest City": Basic sanitation deprivation is punishment in San Diego, California, USA

Safe and consistent access to water, sanitation, and hygiene (WaSH) resources is an internationally recognized human right. Yet in the U.S., access to public toilets, handwashing facilities, potable water, and menstrual supplies is grimly limited, especially for unhoused people. This article develops the concept of "sanitation justice" and argues for its urgent consideration alongside calls for racial, gender, social, and environmental justice. We advance this argument via a case study analyzing three novel data sources on WaSH access in San Diego, California's second-largest city, with a focus on public restrooms: geospatial data on facility locations, infrastructure assessments, and interviews with unhoused people on their restroom needs and challenges. We present a conceptual model, informed by the prior literature and our data, for visualizing how deliberate sanitation deprivation in the U.S. urban environment functions as a punishment regime inflicted on city residents, unhoused residents especially, to the detriment of public health and safety. As our data show, WaSH access is the most basic way governments can support not only public health but also social and economic mobility. We conclude with a vision of sanitation justice that centers the voices of those most affected by sanitation deprivation.