The Romans were in some ways very concerned with public health. Clearly they understood something of the link between cleanliness and good health since they did build myriad latrines, drains, sewers, and public baths. And yet, from shops and from upper windows of apartment houses (insulae), people recklessly tossed rubbish and other waste into the middle of the street with little concern for the consequences. Here's a quick overview of Roman efforts to safeguard public health.
During the Late Republic, water was brought into Rome via aqueducts from the Anio valley, rather than taken from the Tiber river. From the aqueducts, water was piped to public fountains and public baths. In the Late Republic, prior to Julius Caesar´s assassination, Rome was served by four major aqueducts (as opposed to ten during the time of Trajan during the Empire): the Aqua Appia, the Aqua Annio Vetus, the Aqua Marcia, and the Aqua Tepula.
Only the wealthy could afford to have water piped into their homes. This water supply was augmented in the typical Roman domus by rain water which fell into a pool called an impluvium and ran down into a cistern.This rain water was used for household tasks rather than drinking water. Most other people had to obtain their water from the public fountains or by hiring an Aquarius, a contractor whose business was delivering water (Ancestor of today’s bottled water companies? <g>).
Drains and Sewers
Rome had an extensive network of drains and sewers. Open gutters and sewers, for instance, ran down the middle and sides of some of Rome's streets. Excess water from the aqueducts and runoff water from local streams were used to flush the sewers and drains of Rome.
The first major public sewer, the Cloaca Maxima ("The Great Drain"), was originally built by Romans to drain the marshy areas which eventually became the Roman Forum. The Cloaca Maxima–a huge covered drain by the time of the Late Republic–functioned both as Rome's main storm sewer and means of sewage disposal. It emptied into the Tiber river.
Latrines and Other Public Facilities
Most apartment houses (insulae) didn't have much in the way of drainage or toilet facilities; or if they did, such facilities tended to exist only on the ground floor. So most apartment dwellers used chamberpots in their own rooms.
Private homes ( domi ), on the other hand, might have latrines. When they existed, they'd typically lie near the atrium or kitchen of the domus or villa. Again, if there were no toilet facilities, chamberpots were typically used, and the contents would be dumped periodically into cesspits.
As far as public facilities were concerned, urinal pots and public toilets served the public need. In Rome, large urinal pots typically were posted on street corners. Periodically, fullers (the Roman version of a not-so-dry cleaner) would empty them and use the contents in the process of laundering and bleaching togas, tunics, and other clothing.
In many Roman cities there were public toilets. Such facilities were typically just rectangular shaped rooms (some seating as many as 100 people). Arranged along several of the walls of these rooms were long stone benches each with a row of keyhole-shaped openings cut into it. Water running down drains underneath the benches would flush waste away into the sewers. Sponge-sticks were used instead of toilet paper (which, of course, did not exist at this time). One source I encountered indicates the sponge sticks were doused in a water trough in between uses (I don´t know yet what provisions the Romans made for freshening the water in the troughs). Another source indicates that in front of the seats was a gutter with continuous running water for washing (I suspect this might be during the time of the Empire, though. Does anyone know for sure? If so, contact me and point me to a reference.).
More like health clubs than just places to go to take a bath, public baths played a role in Roman life from the third century B.C. to the end of the Roman Empire nearly 800 years later. Initially the baths were viewed as a luxury, but by the Late Republic going to the public baths regularly was regarded as a necessity. Public baths were not just seen as a place to get clean, but they served as a place to meet and socialize with friends, a gathering place to tap into local and city gossip, a place to get an athletic workout, and a place to get warm in the winter (baths were some of the only buildings to have furnace heating). In addition, the baths often had built-in latrines which recycled bath water to carry away the waste.