Tennessee is ranked 47th in the nation for infant deaths.
Every 12 hours, an infant in Tennessee dies before his or her first birthday.
In 2011, 17 percent of pregnant Tennessee women smoked.
While babies are born preterm at a rate of 11.5 percent, black babies are born preterm at a rate of 17.5 percent.
Sources: America's Health Rankings, 2013 Tennessee Women's Health Report Cards, March of Dimes Premature Birth Report Card
In Tennessee, black babies die within their first year twice as often as white babies.
It's a sobering disparity, but not one that a group of 10 Hamilton County high school girls are willing to sugarcoat.
"We want to state cold, hard facts," said Maya Thirkill, a 15-year-old sophomore at Center for Creative Arts. "Because we're saying them so bluntly, it's easier for people to accept."
Thirkill is a part of a group called IMPACT - Infant Mortality Public Awareness Campaign for Tennessee - which is part of Girls Inc. of Chattanooga, and is funded by Blue-Cross BlueShield of Tennessee's Health Foundation.
The group works to educate its peers, both future moms and teen moms, about how they can reduce the risk of a child dying in the first year.
The group estimates it reached 730 Hamilton County middle and high school students last year.
In the county, the disparity is even wider than Tennessee figures. In 2011, an African-American mother is almost five times more likely to lose a newborn infant than a white mother, a 2013 study by the Ochs Center for Metropolitan Studies reported.
The 18 percent infant mortality rate for African Americans in Hamilton County is greater than rates in Mexico, Romania, Oman, Panama and other less developed nations, the study found.
The IMPACT girls are looking for answers to the crisis both in and outside the Chattanooga area.
Last summer, the group traveled to Wisconsin to study the efforts by a university and public health group to drastically lower infant mortality rates and extreme racial disparities in such deaths.
"We want the girls to learn life skills, and how to advocate for what they believe in," said Phil Trammell, chief advancement officer for Girls Inc. "We want them to learn how to do that in a very responsible, adult manner. We want them to research, and not just go from their gut."
The group returned with several suggestions, which they presented to a group of local health workers at the BlueCross campus on Wednesday.
One idea was to create nurse-family partnerships, which would encourage nurses to expand home-visit programs to schools, where they could work more closely with teen moms.
Hamilton County's teen birth rate - measured per 1,000 females - was 52.8, compared to the national rate of 39.
The teenage birth rate for African Americans is trending downward, but is still higher than that of whites.
The girls are also pushing for more holistic support services for pregnant mothers who have higher risk factors, such as poverty and little access to health care. It's not just about prenatal care, Thirkill said.
"If you're a woman, living on a very limited income, in a violent neighborhood, where you can't even take a walk around the block without worrying, and the only place to get food within a five-mile radius is a convenience store ... how high is your stress level going to be?" she asked her audience Wednesday.
IMPACT also has created a public awareness campaign that includes a series of provocative billboards, like one with a cigarette floating in a baby bottle.
"You Smoke, They Choke!" the message reads.
The newest billboard, unveiled this week, depicts a black mother cradling her pregnant belly.
"Black babies die two times more than white babies," the billboard reads.
Anjali Chandra, a junior at Girls Preparatory School, explained that the billboard was designed to turn heads.
"In order to establish the most effective eradication strategy, we cannot simply issue a blanket statement and claim that infant mortality affects all mothers in the same way," Chandra said.
At the bottom of the billboard, the group added a postscript:
"Every baby deserves a chance."
Contact staff writer Kate Harrison at firstname.lastname@example.org or 423-757-6673.