Post-Thanksgiving Covid Testing in Belmont/Lexington on Dec. 4-5: Register Now

Photo: Covid testing will be held in Belmont and Lexington this week

In an effort to curb the spread of COVID-19, Belmont is partnering with Lexington to offer free COVID-19 PCR testing following Thanksgiving. There will be two upcoming testing events, and both are open to residents of Belmont and Lexington, regardless of the testing location.

Testing for the virus remains one of the most important tools we have to slow and stop the spread of COVID-19. Celebrate safely with your loved ones this holiday season and take advantage of this free testing service for residents.

You must have an appointment to be tested. Proof of residency is required. Testing is available for anyone who has reached their first birthday.

The dates and locations are:

  • Saturday, Dec. 4 from 9 a.m. to 1 p.m.
    Chenery Middle School, 95 Washington St., Belmont (indoor testing)
    Limited walk-ins may be accepted 9 a.m. – 11 a.m., appointments strongly recommended.
  • Sunday, Dec. 5 from noon to 5 p.m.
    173 Bedford St., Lexington (drive-through testing—remain in your car)
    No walk-ins will be accepted at the Lexington event.

Register for a COVID-19 test on either Dec. 4 or Dec. 5 here:
Registration Link

PhysicianOne Urgent Care will be providing the testing.  Please note: You will need to set up an account on their website through the highlighted link below to register for a COVID-19 test, and to view your test results.

Further Info and Tips:

PhysicianOne Urgent Care uses the Project Beacon online platform for account registration and test scheduling. If you have any issues with registration or scheduling, please contact Project Beacon by email at help@beacontesting.com, or call 617-741-7310, Mon.-Fri. from 8 a.m. to 4 p.m.

1 in 5 Middle School Students Consider Self Harm, 9 Percent 7-12 ‘Made Suicide Plans’: Youth Risk Behavior Survey

Photo: the 2021 Belmont Youth Risk Behavior Survey (credit: CDC)

Jamal Saeh was shocked by what he had heard.

In March, 89 high school students and 56 middle schoolers in Belmont told health professionals that in the past year they had gone so far with a possible suicide to write out or record plans on taking their own lives.

“To say I’m stunned is an understatement,” said Saeh. “[It’s] mind boggling and frightening.”

The concerning statistics come from the 2021 Youth Risk Behavior Survey of Belmont’s 7-12 grade students presented to the Belmont School Committee on Nov. 9.

The survey’s data justifies Saeh concern: in terms of raw data nearly one-of-five middle school students has considered suicide and approximately 9 percent in both high and middle schools have gone so far as to detail the ultimate act of self-harm.

And among students who identify as gender Queer, the percentages are exponentially greater; 36 percent in high school have considered suicide while 31 percent have planned suicide.

“That is way too many kids,” said Lisa Gibalerio of the Belmont Wellness Coalition who authored the survey with the Education Development Center.

The survey comes as school systems nationwide are witnessing “a growing crisis” on mental health and risk issues, said Committee Chair Amy Checkoway. “Districts are not equipped to handle the number of issues that are arising,” she said after attending a conference of school committees.

The survey is the second conducted by the coalition surveyed a statistically large 1,710 students in 7 – 12 grades (655 at the Chenery Middle School and 1,055 at the high school) on substance abuse and mental health concerns before (in 2019) and during the Covid year 2021.

A PowerPoint summary of the survey can be viewed by linking to this site.

Survey highlights include:

  • a reduction in use of most drug categories including vaping and marijuana from 2019 to 2021.
  • a decline in bullying in the high school while it’s in-school bullying at the middle school has increased.
  • Stress continues to lead to loss of sleep and coping through risky alternatives such as alcohol and drugs.

The survey also looked at the top five stressors at the middle and high school, according to Ellie Lesser, a Belmont High sophomore serving as the study’s student ambassador. A third of all students point to school demands as the top reason for pressure in their lives with a busy school and extra curricular schedule and worries about the future such as college choices and career paths.

The Covid pandemic which halted in-school learning for more than a year added more to the plate of students with 70 percent feeling angry, fearful and sad.

For Belmont Superintendent John Phelan, the survey’s results are “startling” just how much stress – which has been at consistent levels for several years – is impacting so many students and how vulnerable they are to the repercussions that include abusing alcohol and self-harm. In recent years, Phelan admitted the district has not been keeping up with the professional services that students and staff need such as adjustment counselors, consulting services and professional development for teachers to identify and assist students.

But change has occurred during the pandemic. He pointed to the district hiring four social workers – the first hired by the district since Phelan came to Belmont in 2013 – in the current school year to meet the increasing demands for their services. He said the survey data calls for a two-fold approach focusing on providing community and school support from social emotional assistance.

“And [that district-wide clinical model] will be part of what we’re asking for moving forward,” Phelan told the committee.

“School is just not a place where it’s all about academics. If we are not having children feel safe, heard and valued, and able to be respected and known by the adults in the building, they’re not going to learn,” said Phelan.

The committee members all expressed a need not to allow the issue to fall by the wayside.

”The numbers should shock us,” said Mike Crowley of the data on suicide planning, which should force the committee to support the clinical model in future budgets. In additional, a community conversation with students, parents, the public and educators “because any child would be thinking of self harm in our schools, our community, we have to be concerned.”

Saeh said the conversation on risk behavior must be followed up with additional meetings on the proper level of staffing and assistance to students “because we cannot look at his data not react with incredible urgency.”

By reviewing the pre and post pandemic numbers, “the pandemic is not necessarily the culprit here, this is the environment of our high school and middle school,” said Saeh.

Ann Wang of the Education Development Center said Belmont can find successful programs being used in nearby communities such as Lexington and Newton which had student suicides. “These appear to have some impact that can be measured in reducing suicide attempts,” she noted.

Phelan said the solution in the schools is to start to put in place multiple layers of support to students at every level of the district.

“We are not looking to put numbers [in the upcoming school budget] right now, but we want to acknowledge the need and start with students talking about solutions and then start to price out those solutions so that the community can know whether they’re going to support that need or not.”

Racist, Homophobic, Anti-semitic Graffiti Continues To Be Found At Chenery Despite School-Wide Anti-bias Efforts

Photo: Chenery Middle School

“Kill gays.” “Kill N——rs.” Swastikas.

These are recent examples of hate graffiti found in the bathrooms of Chenery Middle School, all coming after the district school for the town’s 5th to 8th grade students held a school-wide effort to address hate symbols earlier in the month.

In a Tuesday, Oct. 26 email to students and parents, Chenery Principal Karla Koza said hate writing and symbols were found inside student restrooms in the past week, coming a fortnight after the staff and teachers held a school-wide observance to address hate graffiti in the school. These incidents come the same time a racist message was left in the Belmont High School library during an open house.

“Your teachers, our staff, our administration and I are deeply disappointed that this continues. I know most of you do not want this type of hate speech in our school either,” said Koza writing specifically to her students.

“Please remember that all students belong at Chenery. When we see terrible things on our walls, it makes us uncomfortable, makes us feel unsafe, and does not help us to feel connected as the great school we are,” said Koza.

Hate-filled graffiti has an unfortunate legacy at the Chenery. Three years ago, a bathroom was tagged with racist and homophobic language in an unprecedented attack of hate speech at the school. In response to the act, Chenery Principal Micheal McAllister conducted a school-wide activity to explain what happened and what students can do to begin the healing process.

“[W]e continue to see vulgarities and graffiti that erodes the sense of community and safety for our students,” said Koza addressing parents and guardians, adding “[t]hreatening racial and homophobic slurs have no place at Chenery Middle School and do not align with our core values to provide a safe and supportive environment for all students.”

Koza said she will address the matter at Wednesday’s morning announcements. Moving forward, school leaders “will continue to address this hateful graffiti by investigate the incidents and follow up with students and families as needed.”

The District School Resource Officer has been notified while Chon’tel Washington, the district’s newly-hired Director of Equity and Inclusivity and community liaisons including the Belmont Human Rights Commission will serve as resources to the greater Chenery community.

“We urge families to talk about these issues at home,” Kona asked parents. In addition, students may reach out to any trusted adult at our school for support or clarity while Belmont community members may also reach out to the Belmont Human Rights Commission for support.

All Student COVID-19 Vaccine Clinic at Chenery Middle School, Thursday, Sept. 30

Photo: Shots for students this Thursday. (Image credit: CDC “Getting Your COVID-19 Vaccine”)

The Belmont School District in partnership with VaxinateRx and Healthcare Family Pharmacy is offering two doses of Pfizer COVID-19 vaccination series to all Belmont public school students ages 12 and up on Thursday, Sept. 30, 10 a.m. to 1 p.m. in the Chenery Middle School large community room.

According to Beth Rumley, director of nursing for the Belmont Public Schools, all students will be vaccinated free of charge regardless of insurance coverage. If insured please enter insurance information in the online registration. Once registered online there is no need to bring an insurance card to the clinic. 

A follow-up clinic for second doses will be held on Thursday, October 21, 2021, 10 a.m. to 1 p.m., in the Chenery large community room. An additional registration link will be provided to register for the second dose at a later time. Students who have already received their first dose of the Pfizer series at another location are welcome to register for either date to receive their second shot as long as there have been at least 3 weeks between doses. Please remember to send the vaccination card from the previous vaccination and consent form with your student.

IMPORTANT THINGS TO KNOW

  • Please register your child to receive the vaccine at: Appointment Quest Scheduler
  • After registering you will receive an email with a link to the consent form for vaccination (please check your spam folder if you do not receive it)
  • Please fill out and print the consent form to bring to the appointment
  • For anyone under the age of 18, a consent form signed by a parent/guardian must be presented in order to receive a vaccine
    • Parent/guardian does not need to be present as long as the child has a signed consent form

If you experience any issues with the registration process please email info@VaxinateRx.com  to resolve any issues.

Reminder: Please make sure to print and sign the consent form and have the student bring it to school on the day of the clinic. A Parent or Guardian signature is required for any students under the age of 18.  

Your child will receive a COVID vaccine card at the time of vaccination. PLEASE KEEP THIS CARD IN A SAFE PLACE. Your child will need it for the second dose.

Chenery Educator Zmijewski Lin Named Teacher Of The Year By National History Day

Photo: Suzanne Zmijewski Lim, Patricia Behring Teacher of the Year Award winner in the Junior Division (6th to 8th grades) by the National History Day Contest

When Suzanne Zmijewski Lim, an eighth-grade history educator at the Chenery Middle School, heard she was named the Patricia Behring Teacher of the Year Award winner in the Junior Division (6th to 8th grades) by the National History Day Contest, her first reaction was to burst into tears.

“The Zmijewski women are happy criers, and I was so honored to be chosen,” said Zmijewski Lim in an email interview with the Belmontonian.

The award is sponsored by Patricia Behring in recognition of the pivotal role teachers play in the lives of students. As the winner of this award, she will receive $10,000, according to a press release from the NHDC. Zmijewski Lim received the award during National History Day’s live-streamed National Contest Awards Ceremony on Saturday, June 19.

“I have put my heart and soul into History Day during my entire 26-year career (plus another year when I did my student teaching at Belmont High School), so I was grateful that my work was recognized in this way, especially in such a difficult year,” she said.

By studying history, students learn about cause and effect, how to have civil discourse, and how to evaluate and make arguments.

Suzanne Zmijewski Lim, Chenery Middle School

National History Day is a year-long interdisciplinary program focused on historical research, interpretation, and creative expression for students in grades 6-12. A student-led project by design, NHD asks students to conduct primary- and secondary-source research on a historical topic of their choosing and present their work through a documentary film, website, performance, paper, or exhibit. Students can compete at local, regional, state, and national levels with the opportunity to win prizes and recognition for themselves and their school. Approximately 6,000 students annually participate across the Commonwealth, sponsored in the state by the Massachusetts Historical Society.

With increasing demands are placed on the middle school curriculum in the past decade highlighted by an increased emphasis on STEM (Science, Technology, Engineering, and Math) and advanced maths classes, Zmijewski Lin believes it is equally important to study history, as it helps people understand their world and their government.

“History is useful as middle school students develop their own identity and figure out how they can contribute to their community and nation. By studying history, students learn about cause and effect, how to have civil discourse, and how to evaluate and make arguments,” she said.

Zmijewski Lin said those Chenery students who seek academic challenges are drawn to the National History Day competition.

“While it is open to all 8th graders, I often invite students I know would love it or who would benefit from pushing themselves to learn new skills. A number of parents also contact me directly because they have heard of History Day and want their students involved. There is a lot of choices within History Day including topic, partners, and type of project, so students get excited about exploring subjects they are passionate about,” she noted.

As examples of students who tested themselves with NHD projects, Zmijewski Lin points to rising Belmont High School 9th graders Sam Geiger and Isabella Hu. 

“In addition to spending hours researching his topic ‘How Feminism in the 1920s Affected Fashion,’ Sam made a professional-looking website and was able to connect to his new sewing hobby by making a dress as part of his project. Isabella wrote an amazing paper on the use of spy satellites during the Cold War which went all the way to Nationals. Both of them really threw themselves into the project, learning and practicing many skills along the way,” she said.  

Zmijewski Lin’s work and passion for NHD was recognized by state and national colleagues.

“Sue is an exceptionally talented teacher, admired by colleagues, administration, and students alike,” said Dr. Elyssa Tardif, director of education at the Massachusetts Historical Society. “Her warmth and guidance are remembered by students years after they’ve left her classroom. In fact, one past NHD student wrote: ‘your class, as well as the whole NHD experience, helped me love learning and believe in myself more.’ Sue embodies the best of what NHD teachers can offer students, and we are incredibly proud to have her representing the entire NHD in Massachusetts program.”

And how will Zmijewski Lin use the award to promote history and NHD activities in Belmont schools? 

“That is a great question! I actually haven’t had a chance to catch my breath after hearing that I won the award, so I will have to think about that over the summer,” she said.

To learn more about how to get involved in NHD, visit masshist.org/masshistoryday.

Incident Targeting Chenery Asian Student Being Addressed With ‘Seriousness It Deserves’ – Chenery Principal

Photo: Chenery Middle School, Belmont

The principal of the Chenery Middle School said her school community is taking an “upsetting incident” against an Asian student will be addressed “with the seriousness it deserves.”

In an email to parents dated Wednesday, May 5, Chenery Principal Karla Koza said earlier in the week, as the Upper School student (7th and 8th grade) was walking to class they were spat upon by another student.

“At this time, it is not clear if this was a racially motivated incident. However, considering the times in which we are living we are addressing it with the seriousness it deserves,” said Koza, referring to the rash of attacks on Asians since March 2020 with the arrival of COVID-19. On Tuesday, May 4, research by the forum STOP AAPI Hate reported nearly 3,800 incidents involving Asians over the past year.

Koza said the school has responded with the following steps:

  • Administration and guidance met with the student to better understand what happened.
  • Administration and guidance met with the family to review the incident and address concerns and next steps for their child.
  • Our School Resource Officer was notified.
  • An investigation is in process to identify the other student involved.

On Wednesday, Koza spoke to students and staff about the incident.

“The resounding essential message is that there is no place for hate in our school. We all belong. We all deserve to be respected and cared for. I drew attention to the growing Asian hate that has been happening in this country and clearly articulated that it and any hateful acts are not acceptable,” she said.

Koza hopes that parents will have a conversation with their children to underscore the shared values of belonging and mutual respect. “To our AAPI community, please know that we support you and your children. We will not tolerate hate in any form.”

“I am particularly proud of the student who came forward to let an adult know this happened. I urge all community members to speak up in order to help us all be better and do better,” said Koza

Belmont Readies For Schools Reopening As District Defends Restart Process; A Question of Whose Mandate

Photo: The elementary schools will be open for business on April 5 … if not sooner.

Days after the state’s education set dates for reopening of elementary schools, the Belmont School District revealed on Tuesday, March 9 its plan that will allow the district’s youngest students to return to full-time in-school classes on Monday, April 6.

Created from recommendations by the Return to In-Person Learning Working Group, the blueprint will provide an educational experience for children in Kindergarten to 4th grade lacking since exactly a year ago this week.

“Our administrators and administrative team at the central office have been working hard on this for over a month and a half and we’re glad we are making progress … and to let our families know that as we try to finish this year as strong as possible, that we are prepared to have a goal of opening [schools] in-person learning next year,” said John Phelan, superintendent of Belmont District Schools as he presented the plan to the School Committee at its regularly scheduled Tuesday meeting.

The new plan was being developed by the Working Group when the state’s Department of Elementary and Secondary Education (DESE) which oversees public education in Massachusetts, issued an edict requiring districts to replace their hybrid systems in elementary schools with full-day in-school classes.

The plan for in-person schooling at the town’s four elementary schools has been discussed for the past two weeks by the working group, school committee and district with the final recommendations released Tuesday:

  • Students in school 5 days/week with the same timing as our pre-Covid school schedule;
  • Offer academics, specials (art, physical education), lunch, and snacks as part of the school day. Lunch and some electives classes will be made possible by setting up large wedding tents at each elementary school and a pair at the Chenery Middle and Belmont High schools.
  • Include specialized instruction for students with disabilities and students who are English learners; 
  • Provide bus transportation to all student in accordance with DESE guidance;
  • Implement classroom capacity, individual distancing, and quarantining requirements from CDC and DESE guidance.

Parents who’ll choose to have their children attend classes remotely will also attend school five days per week. Yet one “trade-off” of moving to a full-time school day will be the end of live streaming that allowed for in-class and at-home students to learn together. This will likely require many remote students to “loss” their current teachers who will transition to in-class teaching, replaced by remote-only educators.

“These are some of the challenges that we are facing in order to be able to provide these two learning models,” said Phelan.

Parents were sent a survey last week on which learning model they would choose for their students which will, in turn, determine how many teachers would be in the classroom and those teaching online.

More specific information on in-school elementary education can be found in the form of a PowerPoint presentation at the Belmont Public School website which was presented at the Tuesday School Committee meeting.

You can see the March 9 Belmont School Committee meeting at Belmont Media Center here.

Phelan noted DESE is requiring middle schools to follow the elementary schools in full-time in-school learning by April 28. And even though the state has not made any time certain for high school students, Phelan said the Working Group will be moving forward on recommendations for reopening the middle and high school.

Tuesday also provided an opportunity for Phelan to defend the district and school committee’s deliberative approach to reopening the schools to the criticism from many residents who felt the superintendent and committee members were ignoring physical data compiled by parents indicating students could have safely returned to classrooms earlier in the school year.

“Why in person now versus earlier in the school year than in the winter,” Phelan asked as he spoke of the success of the Return to In-Person Learning Working Group in formulating the recommendations using data and information gathered internally. The superintendent pointed out that the following guidance from the United States Centers for Disease Control and Prevention (CDC) that only within the past few weeks had it become the optimum time “about bringing more students back to schools.”

“But back in February and January, that was not the case,” he said.

Whose mandate is it anyways?

In a sidebar to the meeting, a question of who has the mandate to speak for educating Belmont students could preview issues facing the Belmont School Committee after Town Election when new members come on board.

Committee member Mike Crowley chided the emergency mandate from DESE Commissioner (and Belmont High alum) Jeffrey Riley directing children back in the classroom either absent of any guidance on a number of issues including the social distancing for unmasked activities and conflicts with union bargaining agreements or “that “DESE guidance seems to be updated about every five minutes,” said Andrea Prestwich, school committee chair.

“I do not like that DESE has usurped the authority of the school committee to make decisions about these planning efforts. This is work that we asked for,” said Crowley, a sentiment seconded by Prestwich, saying she was “holding my tongue about my feelings about DESE, but you did say it nicely.”

Crowley’s statement is hardly a lone voice in the wilderness as many school committees, teacher unions and associations came out to pan Riley’s seeming overreach into local governance. Phelan joined a large group of nearby superintendents in signing a letter asking DESE to work with school districts to come up with a more concrete plan for a return to school, including joining the effort to vaccinate school staff.

While current members were expressing disappointment with the state, School Committee candidate Jamal Saeh, whose run for office is fueled by a growing populism among a segment of the community critical of what they perceive as unwarranted delays in reopening schools, wasted little time in castigating Crowley for his critical take on the state’s intrusion in the running of local government.

“When I hear a school committee member say that DESE usurped the authority of the school committee, I feel compelled to amplify the voice of those parents’ opinion of the school committee [that it] is not the mandate of the community,” said Saeh.

Saeh’s apparently offhand comment was interesting in so much that an elected school board, by state law, was provided a mandate by voters to run the municipality’s schools including managing its own budget, independent hiring practices, and creating policies on how to educate its students.

As Belmont Moves Back To Green, Schools Reports 5 Positive Cases In November

Photo: Back to green for Belmont in coronavirus cases

After a week in yellow, Belmont has returned to the state designated safer green level of COVID-19 infection, according to the Massachusetts Department of Public Health in its weekly coronavirus update on Friday, Nov. 6.

The total number of positive cases in Belmont increased by 24 to 308 total cases (since March 13) in the past two weeks, according to the MDPH, resulting in a 4.4 average daily incidence rate per 100,000 over the same period which lies within the state’s green level, which indicates a low risk of infection within the community.

In the view of the state, Belmont has seen “No Change” in the number of new cases occurring over the current two-week period ending Nov. 5 compared to the previous two-week period.

In the first week of November, the Belmont School District reported five new cases at its six schools.

On Nov. 2, two members of the Belmont High School community (they can either be staff or students) were confirmed to have COVID-19. Both individuals were remote (not in the building) and unrelated to each other. In addition, each did not have contact with others in the district.

Three cases were reported on Nov. 5, one at Belmont High School and two at the Chenery Middle School. While the person at the high school and one of the cases at the middle school were not in the buildings and not in contact with others, the second middle school case was at the school and was in close contact with others. Those who were in contact with the person are in quarantine for the next two weeks.

Third COVID Case In Belmont Schools As A Chenery Staff/Student Tests Positive

Photo: Chenery Middle School

A Chenery Middle School community member – either a student or staff – has tested positive with the coronavirus, according an email from Belmont School District Superintendent John Phelan.

The Belmont Health Department sent the district confirmation on Wednesday, Oct. 14 at 11:45 a.m. This is the third person who either attended or worked in Belmont schools to come down with the COVID-19 virus in the past three weeks. Just last Friday, a positive case was reported at Belmont High School. In late September the first case in Belmont was reported at the Winn Brook Elementary School.

Unlike the earlier incidents, the person was present at school and in close contact with others during their infectious period which is two days prior to becoming symptomatic or, if asymptomatic, two days prior to testing, up until the time the student/staff/teacher is isolated.

Individuals who were in close contact with the community member have been notified privately and should be tested, said Phelan. Regardless of test results, those who were in close contact must self-quarantine for 14 days after the last exposure to the person who tested positive.

To further prevent transmission of the virus to other staff and students, the district has sanitized the school with a focus on the areas frequented by the community member that tested positive.

“Although we cannot provide specific information about our school community member who tested positive, please continue to monitor your child for symptoms, and keep your child home if he/she/they shows any symptoms or is not feeling well,” said Phelan.

Breaking: First Coronavirus Case In Belmont Confirmed, Attended Biogen Conference

Photo: The Belmont resident with the coronavirus attended a Biogen conference at the Boston Marriott Long Wharf (Google maps)

Belmont’s first positive Coronavirus case in a resident has been confirmed by the Massachusetts Department of Public Health, according to a press release dated Wednesday, March 11 from Wesley Chin, director of the Belmont Health Department.

“The presumptive positive individual is in good spirits and reports mild symptoms,” said Chin.

A parent of students who attend the Chenery Middle School and Belmont High School, the resident took part in a Biogen conference at the Boston Marriott Long Wharf in late February which is “Ground Zero” in the spread of the respiratory disease. As of Tuesday, approximately 70 out of 91 presumptive positive cases in Massachusetts are linked to that leadership meeting.

Only the parent has shown symptoms of the virus known as COVID-19; the students and other members of the family are symptom free.

The resident and the family are now complying with a 14-day in-home quarantine protocol provided by MDPH, said the press release. The individual is isolated in the home and is staying away from members of their family.

Even before the confirmation, the individual and its family have been out of school and work since the previous week as a preventative measure to reduce the chance of community spread.

In light of the first positive case in town, the Belmont Public Schools Facilities Department is cleaning and disinfecting the schools the children attend as well as the Belmont Public Library, which was cleaned prior to opening today.

The school department has strengthened cleaning protocols at all schools, with a focus on high touch points. It is also closely monitoring hand towel and soap dispensers to ensure regular refill and has ordered a large supply of hand sanitizer and disinfecting wipes to be distributed to all schools.

There are now plans to systematically disinfect all other town buildings moving forward, said Chin.

Local health departments, including the Belmont Health Department, conduct contact investigations of confirmed and presumptive positive COVID-19 cases, in collaboration with MDPH. This helps to prevent further spread by having contacts of cases self-quarantine.

The US Centers Disease Control (CDC) has updated recommendations for people at higher risk — older adults and people who have chronic medical conditions like heart disease, diabetes, and lung disease.