Native communities should adjust their practices to patients' cultures, particularly by increasing attention to spirituality. There have also been efforts to increase understanding of how the symptoms of DSM-recognized disorders may differ in indigenous communities as a result of different cultural practices. American Indian and Alaska Native youth are slightly less likely than non-Hispanic white youth to receive specialty mental health services, they are significantly more likely to receive non-specialty mental health services such as counseling from social workers, school counselors, and pediatricians. Alcoholism in American Indian and Alaska Native populations has often been studied, although the rates found depend on both the statistics used and how the statistics are divided. One study from 1995 found that 26.5% of deaths for American Indian and Alaska Native men were alcohol-related, while about 13.2% were for women. Another study from 1996 found that in 1993, 34% of adolescents (grades 7–12) reported they had ever been drunk. Historically, the perceived rates of alcoholism in Native Americans led to the stereotype that they are genetically more prone to alcoholism. This stereotype has been called into question, with modern researchers instead focusing on how historical trauma and PTSD are correlated with alcoholism. Maternal and child health Maternal mortality rates are 4.5 times higher for American Indian and Alaska Native women than they are for non-Hispanic white women in the United States. Between 2008 and 2012, 5.3% of American Indian and Alaska Native women giving birth were diagnosed with gestational diabetes compared to just 3.7% of non-Hispanic white women. American Indian and Alaska Native women also are less likely to receive prenatal care than non-Hispanic white women in the United States. Only 60.4% of American Indian and Alaska Native women receive prenatal care in their first trimester, compared to 81.6% of non-Hispanic white women. Additionally, American Indian and Alaska Native women are significantly more likely to not begin receiving prenatal care until their third trimester – 9.3% of American Indian and Alaska Native women compared to 2.9% of non-Hispanic white women. Whereas only 0.8% of non-Hispanic white women do not receive any prenatal care throughout their pregnancy, 2.3% of American Indian and Alaska Native women go entirely without prenatal care. The infant mortality rate for American Indian and Alaska Native populations also exceeds that of non-Hispanic white identifying people in the United States. American Indians and Alaska Natives experience an infant mortality rate of 8.4 per