COVID-19 Lockdown Policies and Health Equity in Tremont, Bronx

Introduction and Overview

The panic surrounding the 2020 COVID-19 pandemic led to new administrative challenges regarding protecting and serving communities simultaneously. Many cities across America reacted to COVID-19 by trying to curb the virus's spread through the implementation of lockdowns. Local governments enacted 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 in the United States, Mayor Bill de Blasio's office issued a series of lockdown policies beginning in March 2020 (NYC, 2020; Tolentino et al., 2021). These 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 them, there were far-reaching consequences—particularly 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 are 28,095 residents in Tremont, with a median age of 32; 46.46% are male and 53.54% are female. US-born citizens make up 54.9% of residents, non-US-born citizens account for 25.36%, and non-citizens constitute 19.74% of the population. The neighborhood's residents are mostly African American (11%), Asian (23%), and Hispanic (57%)—all groups that have historically faced systemic barriers to economic mobility and healthcare equity (Census Reporter, 2024; Gilbert et al., 2022).

During the major COVID months of 2020—essentially March through September—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. The Bronx consistently led New York City in infection metrics due to social determinants of health. Mayor de Blasio's office responded to this infection rate by restricting the movements and interactions of people whose activities were not deemed essential. In other words, if one was not a frontline worker—for example, in healthcare—one had no need to be outdoors; the goal of the mayor's office was 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 focuses on how these policies affected access to healthcare for the minority population in this community.

The Setting: Tremont Before the Pandemic

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). As a result, minority communities in the area experience higher rates of chronic diseases compared to other parts of the city (Shiman, 2021). For example, the social determinants of health include environmental factors that have certainly affected 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 permitted hazardous industrial activities in the area, which 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, further compounds this vulnerability, 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. This 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).