In my personal statement, I emphasized my desired to serve the underserved. Would that potentially alienate me from states with a lot of urban centers. I assume their are rural communities in almost every state.
Did you specifically state that you wanted to go into rural medicine? If not, I'd keep it general for your PS in stating that you want to work with the underserved (so that preference for one over the other is not highlighted). Once you start applying to different programs (especially those that have primary care programs seeking to train rural physicians, e.g., Wake Forest, Morehouse), talk about your specific interests in rural medicine in the secondary applications.