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What does "upstate" mean in the US?
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It's a New York thing. That state loosely divides into two regions: New York City to the south, and everything else to the north ("upstate"). I have heard people refer to the New York City area as "downstate" but that term is less common.
Similarly, Manhattan is loosely split into its northern portion (uptown), middle portion (midtown), and southern portion (downtown).