The city's infant mortality rate, at 12.4 infant deaths per 1,000 live births in 2007, is higher than the state average of 7.7 deaths for every 1,000 babies born.
Just as troubling for health officials, though, is the fivefold racial disparity. In Richmond, the infant mortality rate for African-American babies is 19 deaths per 1,000 live births compared with about four deaths per 1,000 live births among whites.
In terms of lives lost, 41 Richmond infants died before reaching age 1 in 2007 -- 36 black and five white.
"There are many things that can impact someone having a healthy birth, and we know that smoking is one of those things," said Rose Stith Singleton of the Richmond Healthy Start Initiative, a Richmond Social Services program.