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...

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...…Tremont residents and stakeholders and to examine how these experiences can inform future policy implementation. The qualitative methodology, including semi-structured interviews and document analysis, was outlined as the approach to capture the complexities of these impacts. Ultimately, this research seeks to contribute to a deeper understanding of the consequences of emergency public health measures on marginalized communities and to provide insights for more equitable policy-making in future crises.

Roadmap of the Dissertation

Following this introductory chapter, the dissertation proceeds with a comprehensive review of the existing literature in Chapter Two. This review examines the relevant academic literature on public administration's role in crisis management, the social determinants of health, health disparities, and the impact of pandemics and policy interventions on vulnerable communities. It establishes the theoretical framework that underpins this study and provides a critical analysis of previous research related to the socio-economic and health impacts of the COVID-19 pandemic. Chapter Three details the methodology used in this research. It gives an in-depth explanation of the qualitative research design, including the data collection methods (semi-structured interviews and document analysis), participant selection, data analysis techniques (thematic analysis), strategies to ensure rigor and validity, as well as ethical considerations and any biases. Chapter Four presents the findings of the study, organized around the research questions. It will include rich descriptions of the lived experiences of Tremont residents and stakeholders, as well as relevant contextual information gathered from document analysis. Finally, Chapter Five provides a discussion of the study's findings, their implications, and their significance in the context of public administration. This chapter interprets the results, draw conclusions, addresses the limitations of the study, and offers recommendations for future research and policy. It emphasizes how the lived experiences of Tremont residents can inform more equitable and effective public health strategies, so as to contribute to improved…