Navigating risk and resilience: Community leader and care provider perspectives on climate change and health in rural British Columbia

Communities across British Columbia, Canada, are experiencing direct and cumulative health impacts from extreme weather events, such as heatwaves and wildfires. These impacts exacerbate existing health disparities, especially for communities already vulnerable due to remote geography, socio-economic status, etc. Given this reality, it is valuable for community leaders (e.g., mayors and councillors) to have a sufficient understanding of the local health vulnerabilities associated with climate change. If these health considerations are not recognized or integrated into climate resilience strategies, communities may be left inadequately protected against escalating climate-related health risks. This study explores community leader perceptions of health vulnerability to climate change and extreme weather events. Interviews were conducted with mayors, councillors, government officials, and health and social care providers to gauge their awareness of the health risks posed by climate events to their communities and how their understanding of these risks affects policymaking and planning. Analysis suggests that while community leaders recognize the health risks, they face multifaceted challenges, including financial constraints, staffing shortages, and unclear intergovernmental processes, all of which create an environment where adaptation falters due to insufficient implementation capacity. In conclusion, the climate emergency in British Columbia is not just a test of infrastructure resilience or emergency protocols - it is a test of governance. The increasing burden of the impacts of climate change exposes the fragility of siloed systems and the inadequacy of reactive planning. However, it also creates opportunities for experimentation, coordination, and institutional learning. • Community leaders in BC recognize the health risks of climate change but struggle to act. • Financial, staffing, and institutional barriers hinder local adaptation. • Growing extreme weather events highlight the fragility of siloed systems.