Objective

Lesbian, gay, and bisexual (LGB) orientation predicts greater substance use, treatment utilization, and poorer mental and physical health, but health needs of LGB individuals in substance abuse treatment remain largely unknown. The purpose of this study was to identify differences in mental and physical health needs of LGB individuals in substance abuse treatment.

Methods

Substance abuse treatment admissions data from the County of San Francisco were used in this investigation of differences in mental and physical health problems and service utilization between LGB (n=1,441) and heterosexual individuals (n=11,770).

Results

LGB individuals were more likely to have mental health diagnoses (adjORs ranging from 1.86 to 4.00) and current mental health prescription medications (adjORs from 1.79 to 4.99) than heterosexual counterparts. Gay and bisexual men and bisexual women but not lesbian women, were more likely to be receiving mental health treatment. Gay men and bisexual women were more likely than heterosexual counterparts to report physical health problems. Gay and bisexual men and bisexual women but not lesbian women were more likely to be receiving health care. There were no differences between LGB individuals and heterosexual counterparts in the number of emergency room visits or hospital overnight stays.

Discussion

This study found that LGB individuals entering substance abuse treatment have greater mental and physical health needs than heterosexual counterparts. Implications for healthcare integration, research, and practice are discussed.

A growing body of research suggests that modularity of both gene networks and behavioral phenotypes increases robust-ness and efficiency of the evolution of intelligence by natural selection. It remains far less clear how modularity itselfevolves in the first place. A smaller body of research points to the importance of considering the co-evolution of mor-phology and control systems in autonomous agents. We report research using both simulated and real robots that teststhe hypotheses that (1) genotype to phenotype (G-P) maps that allow for gene duplication evolve more modular structuresthan those that do not, and (2) more modular agents evolve more rapidly. We also provide preliminary evidence related tothe positive effects of morphology-controller co-evolution as compared with the evolution of controllers alone. An new,process rather than part based G-P map is also introduced.

We evolve simple neural network controllers in swimming robots in order to test the hypothesis that, given distinctdimensions of control for the tail structure, evolution will favor the emergence of modular neural networks as most likely toenhance fitness (successful light harvesting). Evolution does lead to improved fitness, but this does not appear to result fromincreases in modularity. However, an unexpected result highlights the importance of embodiment for the evolution of the agent.The output of the neural network controller is high frequency with many extreme excursions, but the actual movements of thetail are damped by the physics of the body as it interacts with the aquatic environment. Subsequent simulations establish therole of these physical parameters in dampening noisy network controller output. Thus, morphology can increase evolvabilityby acting as a low pass filter of high-frequency controller dynamics.