Decades ago, when he was 21, Peter Chiavetta — the son of the founders of the chicken BBQ staple, Chiavetta's — witnessed a car crash that altered his life. 

“I missed a car head-on by a foot,” he said. “It hit the car behind me head-on and split the car open, and there were three young men inside the car. One of them yelled for help. The other two dead already. And I was helpless. I was standing there with a fire extinguisher and knew nothing.” 

After witnessing that crash, he started to volunteer at Fareham Fire Department & Seneca EMS, until he stumbled upon the Adverse Childhood Experience survey (ACEs).

The study showed how traumatic events like experiencing violence, abuse or neglect, or witnessing substance use and mental health problems in childhood, are linked to chronic health problems, mental illness and substance use in adulthood. 

The native Western New Yorker helps connect the dots between childhood trauma and physical health issues for the people he sees in the back of an ambulance when he asks questions that are on the original survey.

The ACEs survey is one of the largest investigations of how childhood abuse and neglect are related to later-life health issues. Kaiser Permanente conducted the survey in two waves in the 1990s with nearly 17,000 participants, according to the Centers for Disease Control and Prevention (CDC).

“I tell my patients all the time if we’re out in the woods and we see a bear we’re going to fight, flight or freeze,” Chiavetta said. “We’re going to run. Our cortisol and adrenaline levels come up. Our immune system comes up in case we get injured. We run into the house, close the door and laugh. Those systems come back to normal — but imagine if you’re a child and the bear comes to the door every day.”

For those children experiencing toxic stress can change how the brain develops and impact things like attention, learning and responses to stress, according to the Center For Developing Child at Harvard University.

ACEs and related social determinants of health like living in under-resourced communities or food insecurity can increase the risk of chronic diseases and leading causes of death like cancers, diabetes, heart disease and suicide. 

Chiavetta notes that many of the people he helps don’t realize how unhealthy their childhoods have been until they are much older. 

“Children only know what they know and they think that is the way that they’re supposed to feel because everybody else must feel this way,” he said. “Because we keep all of this such a secret, they don’t know that they didn’t get cared for and protected and loved as they should have.” 

Experiencing ACEs does not mean a person’s health is written in stone — but to address them on a mass level means preventing them for future children and helping adults who currently live with them, Chiavetta said.

Protective factors include families that have steady employment, college or higher education, children who have mentors and role models outside the home and families that have their basic needs met, according to the CDC.

Other protective factors include safe, stable housing, residents that feel connected and are active, and communities that do not tolerate violence.

When a person can address and validate their experience and learn the skills to cope with the aftermath of their experience, the better their chances are of overcoming the negative health outcomes, and adverse childhood experiences can be prevented by fostering a home and community that is safe and healthy for children.