Significant lagging of the Arctic regions of Russia from the all-Russian values of life expectancy and mortality rates of people of working age is noted at the highest state level as one of the main threats to the socio-economic development of the Russian Arctic and ensuring its national security. This lag is largely due to the negative impact of extreme natural and climatic environmental conditions on the health of the population working and living in the Arctic. The presented article is aimed at systematizing the problems and challenges associated with the impact of the harsh natural and climatic conditions of the Arctic on the health of the population living there, as well as finding ways to adapt the public administration system to these challenges. Based on a critical analysis of scientific literature and official statistical information, the paper identifies the health features and the process of adaptation to the natural and climatic conditions of the Arctic for different groups of the Arctic population: indigenous, old-timers and newcomers. The authors have substantiated that the most vulnerable group of the population, whose health is most negatively affected by the extreme natural and climatic conditions of the Arctic, are migrants. On the basis of generalization of problems and peculiarities of public health of the Arctic population and systematization of the experience of previous scientific research, the directions of adaptation of the public administration system of the Arctic regions to the existing challenges have been developed. These directions are based on a differentiated approach to various groups of the Arctic population: indigenous, old-timers and newcomers. According to the authors, the implementation of the directions presented in the article, as well as the creation of the most favorable socio-economic living conditions, can compensate for physiological losses and improve the health indicators of Arctic residents.