Food is a fundamental component of public health. The consequences of climate change for the food system, and through that system for public health, are predictable yet complex. Complicating this story further is the fact that food production is itself a significant contributor to climate change, and mitigation strategies are, perhaps falsely, viewed as a threat to food security. This chapter uses a food security lens to map climate effects, then explores policy responses, some of which emerge from the food security paradigm, which focuses on the food needs of individuals. The chapter argues, however, that these responses, which tend to emphasize increased production and food aid, are inadequate because, while climate change will likely affect overall food production levels, the greater challenges lie with food access and affordability for low-income people. The alternate paradigm of food sovereignty considers control within the food system. As participation in control serves as a critical bulwark against climate related food system disruption this framework offers another set of useful tools that may help respond to the food system as both a cause and a victim of climate change.