Temporal generalized linear mixed models for monitoring national health behavior using subnational observational data

In 2025, US federal workers responsible for national health surveys were dismissed and federal health departments were restructured, creating uncertainty around future national health survey data collection, and an unmet need to understand national health behaviour trends.This study explores the possibility of using state-level survey data to complement national survey data for years in which national data are not collected, or otherwise compromised, using statistical models.To this end, generalized linear mixed models for time series data are shown to predict national substance use prevalence from subnational data with some accuracy, which may help prevent epidemiological 'blind spots'.