• Tennessee is ranked 45th worst in the nation for infant deaths.
• Hamilton County has the second-highest teen birth rate among peer counties.
• Hamilton County's rates for low-birthweight infants, infant mortality, preterm births and teenage pregnancy all exceed national averages.
• Between 12 percent and 20 percent of pregnant women smoke. Smoking during pregnancy has been linked to 10 percent of all infant deaths.
Sources: Girls Inc., Ochs Center for Metropolitan Studies, Tennessee Department of Health
ATLANTA - When the security guard reached the top of the steps in the small bus parked at the checkpoint of the U.S. Centers for Disease Control and Prevention, he did a double take.
Sitting in the rows were six blazer-clad teenage girls, holding notebooks and ready to show him their photo IDs.
Most of them aren't even old enough for a driver's license - a fact that made the security guard chuckle as he walked down the aisle.
"We don't really ever have students here," he explained to Hannah Vann, coordinator for the group.
Students visiting the CDC usually tour the museum at the main campus in another part of town. For these six teens, their appointment at the CDC Injury Center was all business.
The girls are part of a group called IMPACT, or Infant Mortality Public Awareness Campaign for Tennessee, which is part of Girls Inc. of Chattanooga.
For the past five years, IMPACT members have worked to educate their peers - both future and teen parents - about how they can reduce the risk of a child dying in the first year.
They were meeting with researchers at the CDC to share what they've learned, and to learn more.
"This is a very big deal. It's not very often we get to interact with a group of young leaders on these issues," said Sandra Alexander, expert consultant in child maltreatment at the CDC's National Center for Injury Prevention.
Infant mortality - the rate of babies who die before their first birthday - is a chronic problem in Tennessee, and in Hamilton County.
The infant mortality rate in some Chattanooga neighborhoods compares to that of some developing nations like Romania or Mexico.
IMPACT was created by the governor's office to reduce infant mortality rates. Girls Inc. took over the program, now funded by BlueCross BlueShield of Tennessee, in 2009. Beyond its original mission, the program helps the girls build skills in public speaking, research and networking, Vann said.
The group estimates it reached 730 Hamilton County middle and high school students last year. They've created billboards with messages like "You smoke, they choke!" and "They are what YOU eat!"
They have met with state and national lawmakers and traveled from Washington, D.C., to New York City. Last year they traveled to Wisconsin to learn more about how racial disparity plays into infant mortality.
Now they want to use that data to target all-too-common killers, such as shaken baby syndrome and drug abuse.
"Last year was about learning. This year is about progressing," said Maya Thirkill, a rising junior at Center for Creative Arts and president of IMPACT.
On the bus, the girls sound like typical 15- and 16-year-olds. They chat about music, squabble about where to eat dinner and wish they could go to Six Flags.
But their informal conversation is charged with insights and questions beyond their age.
"It's [infant mortality] something many of my teachers don't even know about," said Deasia Reynolds, a 17-year-old rising senior at Tyner Academy who wants to be a nurse practitioner. "I'm talking about it with everyone these days."
As the girls toured the David J. Sencer CDC Museum earlier that day, they traded thoughts about how public health has changed over the years. Lingering in one room, they chatted about different vaccines and the impact of AIDS on family members.
Conversations like these are why 15-year-old Shelby Davis, who attends Central High School, says she likes spending time with the IMPACT team.
"I'm just not about the drama," she said at lunch. "These girls are into bigger issues."
In a conference room in the CDC campus, 10 CDC researchers gathered to hear the presentation Davis and Reynolds gave. Then the group launched into an hour-long conversation, trading ideas and strategies about everything from educating mothers about safer sleep to better data-gathering.
One researcher said the girls' visit and enthusiasm was "energizing" in her work. The girls, meanwhile, scribbled ideas in the notebooks, things they want to try to implement during the upcoming school year.
Toward the end of the discussion, one of the researchers asked the girls why they had chosen to delve into such a complex and "sophisticated" topic, instead of just sticking with a more traditional campaign to prevent teen pregnancy.
"Once you find out that there are hundreds of these babies who are buried before their first birthday - sometimes with headstones that have no name - it makes you want to do something," Thirkill responded. "It makes you want to save lives."
Contact staff writer Kate Harrison at firstname.lastname@example.org or 423-757-6673.