In the second millennium BCE in Northwest China, human subsistence appears to have shifted away from agriculture and towards a mixed agro-pastoralism subsistence system. This coincided with climate and environmental changes, including the rise of steppe and desert environments. Despite evidence for changes substantial enough to be visible in the archaeological and paleoclimate record for this region, paleopathological data from the early and Late Bronze Age (second and first millennia BCE) in the semi-arid Hexi Corridor demonstrate the human population responded with only slight changes in diet. Improvements are observed in some measures of skeletal pathophysiology and health, including declines in skeletal growth disruption and greater survivorship of physiological insults, throughout the environmental transition. These findings suggest that during the Bronze Age, rather than suffering from resource shortages or a collapse of the socio-ecological system, the people of the ancient Hexi Corridor were part of a resilient adaptive system that could weather climate and environmental changes. Risk-management strategies, including a mixed subsistence system, are likely responsible for the resilience of the system, and the lack of ill health effects from climate change.