The document discusses the application of generalized estimating equations (GEE) for analyzing correlated data in state-level studies, emphasizing the need for proper correlation structures and the challenges faced with sample size and missing data. GEE is presented as a flexible method compared to generalized linear mixed models (GLMM), particularly in accounting for intraclass correlations and producing efficient coefficient estimates. The paper concludes that GEE should be considered a valuable methodological tool for handling real-world correlated data.