January 22, 2025

Capstone Progress

PADM888

AN ASSESSMENT OF MAYOR DE BLASIO COVID LOCKDOWN POLICIES UPON THE MINORITY POPULATION IN TREMONT, NEW YORK

CHAPTER ONE:

INTRODUCTION

Overview

The panic regarding the 2020 COVID-19 pandemic led to new administrative challenges regarding protecting and serving communities at the same time. Many cities across America reacted to COVID by trying to curb the virus's spread through the implementation of lockdowns. Local governments implemented strict measures that changed daily life overnight and exposed the vulnerabilities of already underserved and marginalized communities.

In New York City, one of the worst hit cities of the pandemic in the United States, Mayor Bill de Blasio's office issued a series of lockdown policies starting in March 2020 (NYC, 2020; Tolentino et al., 2021). Policies included the closure of non-essential businesses, the implementation of remote learning, the restriction of public gatherings, and the enforcement of social distancing in essential services (NYC, 2020). Legacy media reported on these measures as necessary to contain the public health crisis; however, for the public affected by these measures, there were far-reaching consequencesparticularly for the population of Tremont in the Bronx.

Tremont is a predominantly minority community in the Bronx (Forster et al., 2024). It has long been characterized by socio-economic disparities, such as high poverty rates and inadequate access to healthcare (NYC, 2020). There are28,095 residentsin Tremont, with a median age of 32. 46.46% are males and 53.54% are females. US-born citizens make up 54.9% of the residents in Tremont, and non-US-born citizens account for 25.36%. 19.74% of the population consists of non-citizens. The neighborhood's residents are mostly African American (11%), Asian (23%), and Hispanic (57%), all groups that have historically dealt with systemic barriers to economic mobility and healthcare equity (Census Reporter, 2024; Gilbert et al., 2022).

During the major COVID months of 2020, essentially March 2020 to September 2020, the New York City Department of Health reported a cumulative infection rate of over 40,000 per 100,000 residents in certain Bronx zip codes, with the Bronx consistently leading New York City in infection metrics due to social determinants of health?. De Blasios office acted in a manner to address this infection rate by restricting the movements and interactions of people whose movements were not deemed to be essential. In other words, if one was not a frontline worker, for example, in health care, one had no need to be outdoors, the goal of De Blasios office being to stop the spread (Erwin et al., 2021).

However, the COVID-19 pandemic lockdown response essentially aggravated already existing challenges for this population by further limiting access to critical services (Tolentino et al., 2021). The purpose of this dissertation is to explore the specific impact of the lockdown policies implemented between March 2020 and September 2020 on the socio-economic conditions of low-income residents in the Tremont neighborhood. In particular, the research will focus on how these policies affected access to healthcare for the minority population in this community.

The Setting

It is important to understand the pre-pandemic socio-economic condition of Tremont. Like many other neighborhoods in the South Bronx, Tremont is home to a low-income, minority population that has experienced continual challenges related to poverty, healthcare access, and environmental racism (Brennan, 2021; Estevez, 2020). The result is that minority communities experiencing higher rates of chronic diseases compared to other parts of the city (Shiman, 2021). For example, the social determinants of health include environmental factors which have certainly impacted the health of Tremont residents. The South Bronx, including Tremont, has been disproportionately affected by environmental hazards, such as poor air quality and high levels of pollution. Estevez (2020) notes that the South Bronx has historically been subject to political…

January 22, 2025

Capstone Progress

PADM888

AN ASSESSMENT OF MAYOR DE BLASIO COVID LOCKDOWN POLICIES UPON THE MINORITY POPULATION IN TREMONT, NEW YORK

CHAPTER ONE:

INTRODUCTION

Overview

The panic regarding the 2020 COVID-19 pandemic led to new administrative challenges regarding protecting and serving communities at the same time. Many cities across America reacted to COVID by trying to curb the virus's spread through the implementation of lockdowns. Local governments implemented strict measures that changed daily life overnight and exposed the vulnerabilities of already underserved and marginalized communities.

In New York City, one of the worst hit cities of the pandemic in the United States, Mayor Bill de Blasio's office issued a series of lockdown policies starting in March 2020 (NYC, 2020; Tolentino et al., 2021). Policies included the closure of non-essential businesses, the implementation of remote learning, the restriction of public gatherings, and the enforcement of social distancing in essential services (NYC, 2020). Legacy media reported on these measures as necessary to contain the public health crisis; however, for the public affected by these measures, there were far-reaching consequencesparticularly for the population of Tremont in the Bronx.

Tremont is a predominantly minority community in the Bronx (Forster et al., 2024). It has long been characterized by socio-economic disparities, such as high poverty rates and inadequate access to healthcare (NYC, 2020). There are28,095 residentsin Tremont, with a median age of 32. 46.46% are males and 53.54% are females. US-born citizens make up 54.9% of the residents in Tremont, and non-US-born citizens account for 25.36%. 19.74% of the population consists of non-citizens. The neighborhood's residents are mostly African American (11%), Asian (23%), and Hispanic (57%), all groups that have historically dealt with systemic barriers to economic mobility and healthcare equity (Census Reporter, 2024; Gilbert et al., 2022).

During he major COVID months of 2020, essentially March 2020 to September 2020, the New York…

January 22, 2025

Capstone Progress

PADM888

AN ASSESSMENT OF MAYOR DE BLASIO COVID LOCKDOWN POLICIES UPON THE MINORITY POPULATION IN TREMONT, NEW YORK

CHAPTER ONE:

INTRODUCTION

Overview

The panic regarding the 2020 COVID-19 pandemic led to new administrative challenges regarding protecting and serving communities at the same time. Many cities across America reacted to COVID by trying to curb the virus's spread through the implementation of lockdowns. Local governments implemented strict measures that changed daily life overnight and exposed the vulnerabilities of already underserved and marginalized communities.

In New York City, one of the worst hit cities of the pandemic in the United States, Mayor Bill de Blasio's office issued a series of lockdown policies starting in March 2020 (NYC, 2020; Tolentino et al., 2021). Policies included the closure of non-essential businesses, the implementation of remote learning, the restriction of public gatherings, and the enforcement of social distancing in essential services (NYC, 2020). Legacy media reported on these measures as necessary to contain the public health crisis; however, for the public affected by these measures, there were far-reaching consequencesparticularly for the population of Tremont in the Bronx.

Tremont is a predominantly minority community in the Bronx (Forster et al., 2024). It has long been characterized by socio-economic disparities, such as high poverty rates and inadequate access to healthcare (NYC, 2020). There are28,095 residentsin Tremont, with a median age of 32. 46.46% are males and 53.54% are females. US-born citizens make up 54.9% of the residents in Tremont, and non-US-born citizens account for 25.36%. 19.74% of the population consists of non-citizens. The neighborhood's residents are mostly African American (11%), Asian (23%), and Hispanic (57%), all groups that have historically dealt with systemic barriers to economic mobility and healthcare equity (Census Reporter, 2024; Gilbert et al., 2022).

During the major COVID months of 2020, essentially March 2020 to September 2020, the New York City Department of Health reported a cumulative infection rate of over 40,000 per 100,000 residents in certain Bronx zip codes, with the Bronx consistently leading New York City in infection metrics due to social determinants of health?. De Blasios office acted in a manner to address this infection rate by restricting the movements and interactions of people whose movements were not deemed to be essential. In other words, if one was not a frontline worker, for example, in health care, one had no need to be outdoors, the goal of De Blasios office being to stop the spread (Erwin et al., 2021).

However, the COVID-19 pandemic lockdown response essentially aggravated already existing challenges for this population by further limiting access to critical services (Tolentino et al., 2021). The purpose of this dissertation is to explore the specific impact of the lockdown policies implemented between March 2020 and September 2020 on the socio-economic conditions of low-income residents in the Tremont neighborhood. In particular, the research will focus on how these policies affected access to healthcare for the minority population in this community.

The Setting

It is important to understand the pre-pandemic socio-economic condition of Tremont. Like many other neighborhoods in the South Bronx, Tremont is home to a low-income, minority population that has experienced continual challenges related to poverty, healthcare access, and environmental racism (Brennan, 2021; Estevez, 2020). The result is that minority communities experiencing higher rates of chronic diseases compared to other parts of the city (Shiman, 2021). For example, the social determinants of health include environmental factors which have certainly impacted the health of Tremont residents. The South Bronx, including Tremont, has been disproportionately affected by environmental hazards, such as poor air quality and high levels of pollution. Estevez (2020) notes that the South Bronx has historically been subject to political practices that have allowed hazardous industrial activities in the area, which have in turn contributed to high rates of respiratory illnesses among residents. These pre-existing conditions made the Tremont community particularly vulnerable. The fact that the Bronx has one of the highest poverty rates in New York City, with many residents relying on public assistance and living in overcrowded housing, makes it particular vulnerable, as socio-economic conditions have long contributed to health disparities in the borough (Clark & Shabsigh, 2022).

Additionally, Tremont residents have faced systemic barriers to accessing quality healthcare (Shiman et al., 2021). The Bronx is home to several public hospitals and community health clinics, but many of these facilities are underfunded and understaffed due to structural racism within the healthcare system, which has contributed to disparities in healthcare access, with minority communities in neighborhoods like Tremont receiving lower-quality care compared to wealthier, predominantly white areas (Shiman et al., 2021).

Research Significance

In Tremont, many residents work in low-wage, essential jobs, often without the luxury of working from home, which increased their vulnerability during the pandemic lockdowns. The area has long faced systemic inequities in housing, healthcare, and employment opportunities, making it one of the most vulnerable communities in the city. Residents were already at higher risk for poor health outcomes due to underlying conditions such as asthma, diabetes, and hypertension (Clark & Shabsigh, 2022; Estevez, 2020). Indeed, Tremont's residents experience higher rates of diabetes, asthma, and hypertension compared to other New York City neighborhoods, which means they were at elevated risks of severe COVID-19 outcomes (Huang & Li, 2022). Case studies on New York City and on the Bronx in particular noted that COVID-19 hospitalizations and mortality were particularly high among residents with such preexisting conditions, which shows the need for targeted health interventions and resource allocation in these communities? (Friedman & Lee, 2023; Huang & Li, 2022).

The importance of researching the impact of Mayor Bill de Blasio's COVID-19 lockdown policies on Tremont lies in understanding how these public health measures worsened existing social and economic disparities for underprivileged populations like the one in Tremont. The argument at the time was hat lockdowns would help to slow the spread of the virus (Hammond, 2021). Major cities like New York City followed federal guidelines in almost all states except those like Florida, where the governor pushed to keep businesses open and people going about life as they were accustomed to do. For the most part, the federal guidelines have been accepted as necessary to meet the challenges of the pandemic. However, little attention has been given to the potential problem of inequalities in healthcare access worsening for low-income, minority communities like Tremont. Tremont residents already faced barriers to accessing healthcare, and in 2020, due to clinic closures, overwhelmed hospital systems, and the lack of technology for telehealth services, the health situation of the community worsened; and on top of all that the Bronx in general and Tremont in particular was home to a uniquely vulnerable population to SARS-CoV-2 infection and severe COVID-19 (Forster et al., 2024). Economically, the shutdown of service industry jobs hit the community especially hard, leading to unemployment, food insecurity, and difficulties in obtaining unemployment benefits, all of which affected the social determinants of health for poor communities like Tremont (Shiman et al., 2021).

Research by Zhong et al. (2022) found that the Bronx communities have the lowest percentage of white residents and that neighborhoods with a higher percentage of Black and Hispanic populations had a higher incidence rate and death rate per capita relative to predominantly white neighborhoods in wave 1 but not in wave 2. This shows that Tremont was vulnerable. According to Zhong et al. (2022), these findings suggest that, neighborhoods at higher risk of morbidity and mortality were less affected by the second wave of the pandemic than the first wave. Overall, the implication is that something happened among these residents to mitigate risk during the second wave. What was it? Zhong et al (2022) offer one explanation: changes in the risk perception and protective behavior among residents in these neighborhoods to better protect themselves from infection. Yet, they admit that future qualitative research is needed in this area to better explain what actually transpired for these residents. That is precis.......is important because it allows for gaining insights into the intended and unintended consequences of pandemic policies on marginalized populations. There is a need to know and understand the specific challenges faced by communities like Tremont, so that policymakers in the future can develop and adopt more equitable approaches to public health crises in the future, and so that low-income and minority populations are not disproportionately affected by similar measures?.

Background to the Problem

COVID-19 Lockdown Policies in New York City

In response to the COVID crisis, Mayor de Blasios office implemented a months-long policy of lockdown. Essential businesses like grocery stores and healthcare providers were allowed to remain open but were required to implement strict social distancing and hygiene protocols to protect both employees and customers (NYC, 2020). Many Tremont residents were employed in these sectors and were unable to work remotely. Helmreich (2023) notes that the economic impact of the lockdown was particularly severe in the Bronx, where a large proportion of residents rely on hourly wages and do not have the financial safety nets that wealthier individuals might possess.

Lockdown policies aimed at controlling COVID-19 spread had significant unintended effects on healthcare access in marginalized areas like Tremont. These disruptions revealed systemic inequities, as many Bronx residents, particularly those with chronic conditions, faced increased barriers to essential care. For example,...

(2023) found that over 54% of New York City residents reported disruptions in accessing healthcare services, with emergency room visits spiking in areas like the Bronx due to limited access to routine medical care during lockdowns. Chronic conditions prevalent in the Bronx required regular management, which was impeded by lack of access care. Consequently, the Bronx saw higher hospitalization rates as residents with unmanaged chronic conditions were forced to seek urgent care?? (Dorvil et al., 2023). Moreover, the closure of schools and the shift to remote learning posed additional challenges for low-income families in Tremont due to the pre-existing digital divide. The long-term effects of this educational disruption are still being studied, but early research suggests that students from low-income households experienced significant learning loss during the pandemic (Friedman et al., 2023).

Perhaps one of the most critical areas affected by the COVID-19 lockdown policies was healthcare access. For residents of Tremont, who already faced significant barriers to healthcare, the lockdown policies further limited their ability to access medical services (Rolds et al., 2024). The closure of non-essential medical facilities, such as primary care clinics and dental offices, meant that many people were unable to receive routine carenot to mention the fact that the policies of the mayors office supported a social stigma already introduced by non-stop media hype of the dangers of going out in public. People were scared and hesitant to seek medical care due to concerns about exposure to the virus. As a result, conditions that might have been manageable under normal circumstances experienced even greater systemic shock during the lockdown period. Huang and Li (2022) point out for instance that spatial health disparities were exacerbated during the pandemic, with low-income and minority communities experiencing higher rates of severe illness and death due to delayed care and reduced access to healthcare resources. Likewise, a core aspect of de Blasios COVID response was to promote telemedicine, but research on digital health disparities has found that nearly 50% of households in the Bronx lacked consistent internet access. Watts and Abraham (2020) indicated that low broadband connectivity in the Bronx limited residents' ability to engage in virtual healthcare consultations, particularly those without smartphones or other devices necessary for accessing telehealth. This gap left many low-income residents with fewer options for medical consultations during the pandemic??.

The pandemic also revealed long-standing issues related to health equity in New York City. COVID-19 mortality rates were disproportionately high in neighborhoods with large minority populations, such as the South Bronx (Friedman & Lee, 2023). Factors such as overcrowded housing, a need to rely on public transportation, and limited access to healthcare contributed to the higher rates of infection and death in these communities (Friedman et al., 2023). The lockdown policies showed little consideration for the underlying structural issues and may have worsened existing disparities. Is this how policy serves a community?

Problem Statement

The core problem this research seeks to address is to understand how the COVID-19 lockdown policies implemented by the New York City government impacted the health and well-being of residents in Tremont. The policies were intended to mitigate the public health crisis, but they may have actually worsened the situation for low-income, minority populations. Understanding the specific socio-economic and healthcare challenges faced by these communities is crucial for developing more equitable public health policies in the future.

The Bronx has consistently exhibited high poverty rates and unemployment, particularly in low-income neighborhoods such as Tremont. Prior to the pandemic, the Bronx had a poverty rate of nearly 27%, the highest of all New York City boroughs (Clark & Shabsigh, 2022). This is an important point because of the social determinants of health, which affect health outcomes in big ways for communities like Tremont. When healthcare access is restricted, and the social determinants of health are worsened due to restrictive policies like lockdowns, it can create a perfect storm that wreaks havoc on community health. According to Shiman et al. (2021), structural racism and inadequate healthcare infrastructure have long affected minority communities in the Bronx and have already contributed to poor health of the population. The COVID-19 pandemic further strained these already limited healthcare resources.

Tremont and other parts of the South Bronx have also suffered from poor air quality and other environmental hazards, which have contributed to higher rates of asthma and other respiratory diseases (Estevez, 2020). This point just goes to show that residents in Tremont were already in a poor health posture before the lockdowns. Helmreich (2023) shows that the lockdown measures significantly increased unemployment rates in the Bronx, where many residents worked in sectors hardest hit by the pandemic, such as retail and hospitality. Without economic support and stability, social determinants of health can quickly disappear leaving residents without health support. All in all, Tremont and similar neighborhoods in the Bronx faced far greater challenges than wealthier areas with more robust digital and healthcare infrastructures, such as Manhattan. These disparities intensified under lockdown. New York City Department of Health data from 2020-2021 showed that the Bronx consistently had higher COVID-19 mortality and infection rates than Manhattan, where residents generally had better healthcare access and digital infrastructure.

The Qualitative Science Method

Qualitative research is a systematic and interpretive approach to understanding social phenomena within their natural contexts (Gephart, 2018). It is particularly well-suited for exploring the subjective experiences of individuals and communities, especially when examining social dynamics in the midst of socio-economic challenges (Gephart, 2018). Through a focus on lived experiences and by incorporating personal reflections from participants, qualitative research allows researchers to gain a deep understanding of how individuals and groups experience and interpret their lived realities (Omston et al., 2014). This method uses an inductive approach to data collection and analysis, allowing themes and patterns to emerge organically from the data. It lets the people speak for themselves and the researcher to see the themes that emerge from analysis of their own words.

A core characteristic of qualitative research is its emphasis on context and meaning, which makes it an invaluable tool for understanding how specific events, such as the COVID-19 pandemic and its associated policies, impact vulnerable populations (Lim, 2024). Through techniques such as interviews and thematic analysis, qualitative methods provide rich, detailed insights into human behavior, experiences, and the interplay of social, ecoomic, and health-related factors (Rana et al., 2023). To examine the socio-economic and healthcare impacts of COVID-19 lockdown policies on Tremont in the Bronx, this study adopts a qualitative methodology because it has both been called for by Zhong et al. (2024) and because it is well-suited to exploring how lockdown policies influenced access to healthcare and broader public health conditions in this low-income, minority community. It also enables an in-depth investigation into the lived experiences of residents and stakeholders, so as to have a lens through which to understand the interplay of health, minorities, and public administration.

The data collection strategy for this study includes semi-structured interviews and document analysis. Semi-structured interviews with Tremont residents, healthcare professionals, local business owners, and educators provide a platform for participants to articulate their personal experiences during the pandemic. This flexible interview structure allows for both guided discussions around key research questions and the emergence of unanticipated insights (Naz et al., 2022). These qualitative methods are complemented by document analysis, which involves reviewing public health data, government reports, and news articles. By triangulating these data sources, the study ensures a more comprehensive and robust understanding of the effects of lockdown policies.

The analysis of qualitative data is grounded in thematic analysis, a method that enables the identification and interpretation of patterns and themes (Naeem et al., 2023). This process begins with the coding of data into manageable units, followed by the categorization of recurring ideas and the development of broader themes. For example, themes such as "barriers to healthcare access" or "economic hardship" may emerge from the data and will be contextualized within the broader socio-economic and policy environment. Thematic analysis not only organizes the data but also allows for a nuanced understanding of the systemic challenges faced by Tremonts residents during the pandemic. Ensuring validity and reliability is integral to qualitative research (Ahmed, 2024). This study employs triangulation by integrating findings from interviews and document analysis to corroborate and enrich interpretations. Member checking, wherein participants are invited to review preliminary findings, ensures that the data accurately reflects their experiences and perspectives. Additionally, reflexivity is maintained throughout the research process, with the researcher actively reflecting on and accounting for personal biases that could influence the studys outcomes (Olmos-Vega et al., 2023).

The qualitative methodology adopted in this study contributes to the existing body of knowledge by providing community-specific insights into the socio-economic and healthcare impacts of emergency public health measures. It sheds light on how systemic inequities disproportionately affect low-income, minority neighborhoods during crises. By exploring the lived experiences of Tremonts residents and stakeholders, this study seeks to inform the design of future public health policies that are both equitable and sensitive to the needs of vulnerable communities.

Research Objectives

The main objective of this dissertation is to examine the impacts of the COVID-19 lockdown policies on the health and well-being of residents in the Tremont neighborhood in the Bronx. Specifically, the research aims to answer the following questions: How did the lockdown policies affect access to healthcare for the minority population in Tremont? What were the broader consequences of these policies, particularly in terms of public health? Through an exploration of these questions, this dissertation looks to contribute to a deeper understanding of how emergency public health measures can impact vulnerable communities and to provide insights for public administrators into how future policies can be designed to consider such effects. In doing so, this research will draw on a range of primary and secondary sources, including public health data, government reports, and academic studies. It will also consider the perspectives of community members and healthcare providers in Tremont, who can offer valuable insights into the lived experiences of residents during the pandemic. Ultimately, the goal of this dissertation is to shed light on the specific challenges faced by low-income, minority communities during the COVID-19 pandemic and to provide recommendations for addressing these challenges in future public health emergencies.

To achieve its objective, this study uses a qualitative research methodology, which is suited because this research requires in-depth exploration of the lived experiences of residents and stakeholders during the pandemic (Crabtree & Miller, 2023). A focus on subjective experiences and community-specific issues can be applied by way of the qualitative methodology, which supports deep understanding of how the lockdown policies influenced healthcare access and socio-economic conditions in this low-income, minority neighborhood (Crabtree & Miller, 2023). Data will be collected primarily through semi-structured interviews with residents of Tremont, healthcare professionals, local business owners, and educators. These interviews will explore their perceptions of the lockdown policies, focusing on their effects on access to healthcare. The semi-structured nature of the interviews allows for flexibility, enabling participants to share personal experiences while ensuring that key research questions are addressed (Crabtree & Miller, 2023). Document analysis will be useful for reviewing local government reports, public health data, and news articles that document the implementation of COVID-19 policies in New York City. This will provide contextual background and help triangulate the findings from interviews. Thematic analysis will be used to identify patterns and themes emerging from the qualitative data. This approach allows the researcher to categorize and interpret the data based on recurring concepts, such as barriers to healthcare or economic hardships. The use of qualitative methods will offer rich, detailed insights into te social and healthcare inequalities exacerbated by the COVID-19 lockdown, contributing to a deeper understanding of its impact on vulnerable communities.

CHAPTER TWO:

LITERATURE REVIEW: THE IMPACT OF COVID-19 LOCKDOWN POLICIES ON HEALTHCARE ACCESS IN TREMONT

INTRODUCTION

This research focuses specifically on the healthcare implications of the COVID-19 lockdown policies implemented by Mayor Bill de Blasios office between March 2020 and September 2020. Through the closing of non-essential businesses and mandating social distancing and remote learning, the mayors policies had far-reaching effects on access to healthcare for minority populations about Tremont. Tremont could stand in as representative, in fact, of low-income, marginalized minority neighborhoods. Thus, understanding how the mayors policies affected healthcare access in Tremont is helpful from a public administration standpoint because it can shed light on the structural vulnerabilities of marginalized communities during public health crises and the extent to which public administrators policies and actions worsen or help alleviate those vulnerabilities. Furthermore, it can provide important insights into how future emergency measures can be designed to protect and support low-income, minority populations more effectively.

Comparison to NY State Standards

De Blasios COVID-19 policies in New York City were designed to align with state and federal public health guidelines, particularly those from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). Although challenging to implement in a densely populated and transit-reliant city like New York City, these policies mirrored broader state and city efforts across the U.S. (Erwin et al., 2021). The differences in resources and logistical challenges between New York City and the rest of New York State provide context for perceived delays and the difficulties encountered during the initial response phase (Tolentino et al., 2021).

Alignment with CDC Guidelines and State Standards

There was nothing comparatively slow about New York Citys response to the COVID pandemic. Essentially, major US cities responded lockstep in unison in terms of strategic response. New York Citys first official lockdown order was issued on March 22, 2020. This came just three days after similar orders in California, where San Francisco and Los Angeles implemented a statewide shelter-in-place order earlier, on March 19, 2020.

By late March 2020, New York City had already become one of the hardest hit major US cities of the pandemic, with significantly higher infection and hospitalization rates than many other metropolitan areas (Tolentino et al., 2021). New York City's early cases grew rapidly due to high population density, reliance on public transit, and what some critics called a slower lockdown imple