Communities on Canada’s east and west coasts have experienced profound changes as a result of environmental and economic restructuring associated with the decline of traditional resource-based industries, principally fishery, forestry and mining. This restructuring has resulted in social changes with potentially major implications for the health and well-being of individuals and communities. Coasts under Stress (CUS) examines the effects of restructuring on coastal communities in British Columbia and Newfoundland and Labrador. Within the CUS project, this study examines the relationship between socio-economic restructuring and health in four BC coastal communities―Port Hardy, Prince Rupert, Tofino and Ucluelet―by a community health survey and in-depth interview studies. The survey which was conducted in the summer of 2002 (N=1,204), collected information on individual health status and stress levels, lifestyles, socio-demographics, social capital and social cohesion in the four communities. Follow-up in-depth interviews were conducted with 41 survey respondents and an additional 25 key informants in early 2003 to explore the factors influencing people’s ability to cope with the impacts of restructuring on individual and community health. The findings of the survey analyses indicate that: the communities lag behind the province of BC and Canada as a whole in terms of self-reported health status; health status differs significantly among the communities as do recent changes in health status and stress level; the main predictors of general and emotional health status and stress are a healthier lifestyle and higher socio-economic status (SES), along with a higher level of community satisfaction. Combining the results from the in-depth interviews and the survey, it is clear that differences in health status are plausibly attributable to restructuring processes and major events in each community. There is a clear linkage between economic downturn and poorer health in the interview study. Furthermore, the interview and survey analyses reveal factors that may affect the vulnerability or resilience of individuals and communities. Employment opportunities are central to the vitality of communities and the quality of life of their residents, and are key factors related to individual and community resilience or vulnerability. The study concludes that socio-economic restructuring has had an impact on the health of BC coastal communities and their residents in the last two decades, especially in the last ten years. While traditionally resource-dependent industries have declined, the emergence of new alternative economic activities has not been strong enough in the coastal communities to withstand the economic downturn brought about by the restructuring process that has increased employment stress for both residents and their communities. Employment stress resulted in poorer health for residents vulnerable to the economic changes, such as people who have lost jobs, who lack social/family support, and who possess low SES. Such employment stress has also affected community health in vulnerable communities, like Prince Rupert and Port Hardy, which have experienced population decline, family break-ups and a variety of social problems. This study adds to the growing population health and health geography literature on the social determinants of health with specific application to advancing the understanding of the complex relationships between socio-economic change in coastal communities and the health and well-being of their residents. The research demonstrates the value of combining quantitative and qualitative methods as complementary approaches to the study of community and individual health. From a policy and planning perspective, the findings inform the debate on factors fostering resilience to restructuring in communities.