Health is a core aspect of human security. Meanwhile human security is considered to reduce disaster risk. However, despite this logically derived association, we could find no studies that provide evidence of how people residing in the world's most environmentally at risk locations view health as a defence against disasters. This article therefore draws on findings from our research showing how people at risk of major climatic events in Bangladesh interpret disasters and accompanying health security indicators. The findings show that health is locally considered a protector against climate-related environmental hazards and that there are differences between individual and community level indicators. Health security in contexts of indigenously defined hazards and disasters at these study sites was based on a combination of economic and social processes related to food, livelihoods and finance. The study shows that health can underpin the means that a local community gains security in contexts of major climatic risks. The study shows the importance of a locally based and people-centred understanding of climatic hazards and disasters and the processes underlying health and wellbeing.