Lessons learned from more than 150 years of public health research and intervention can provide insights to guide public health professionals and institutions as they design and implement specific strategies, policies, and measures to increase resilience to climate variability and change. This paper identifies both some modifications to public health systems that may enhance adaptive capacity, and lessons drawn from the history of managing environmental and other threats in the public health sector that may have relevance for other sectors as they design approaches to increase their adaptive capacity to more effectively cope with climate variability and change.