Federal Refund lower than State?

My girlfriend’s federal refund is significantly lower than her state (NY) one, which is something I’m not familiar with happening before. Why would that be?

For reference, she made ~57k in W-2 income predominantly from the NYC Health+Hospital system before taking a private position in December. She also had ~1100 income from a 1099, although most of that was deducted for expenses. She had a significant medical expense of ~5k as well. She moved from Nassau to Westchester county this year as well.