I feel like in some circumstances, the "underrepresented state" thing works against you unless you're the very top applicant from that area. I'm from Kentucky and I knew a handful of crazy qualified people (including a Native American cancer survivor with lesbian parents, but that's another story) who got into 3+ top 15 schools. But I also knew a group of about 10 people, including myself, all with >4.0,34,2300 stats who all struck out on Ivies/MIT/Stanford etc and the best school any of us got accepted by was Vandy, which recruits pretty heavily from my area. When you think about it, being the 15th most qualified applicant from Kentucky/Wyoming/Mississippi/wherever probably isn't that good when the 14 people ahead of you all applied to the same schools you did.