The work examines the theoretical and methodological foundations of the study of public health, analyzes the trends in demographic development and health of the population of large cities in the period from 1990 to 2009, and also identifies the main determinants of health for the urban population (using the example of Vologda and Cherepovets) and suggested directions for improving the situation. The preprint is addressed to employees of health authorities, managers and specialists of local governments, researchers, teachers of higher educational institutions, graduate students, students, as well as a wide range of readers. Large cities are settlements with a population of 250 thousand to 1 million people (according to the Urban Planning Code of the Russian Federation).