In Canada the quality of drinking water and its availability are a reflection of where one lives. Coastal communities, which are particularly susceptible to boil water advisories, present an understudied opportunity to understand drinking water-related behaviours and perceptions. How public health practitioners determine actions needed to prevent water-borne illness is a key factor in the public adopting messaging and/or employing behavioural change. This study involved face-to-face surveys with residents in eight coastal communities in British Columbia and Nova Scotia. All communities had recent histories of boil water advisories and/or water shortages. The findings have significant implications for public health practice seeking to reduce the incidence of water-borne diseases. For example, the respondents had a limited sense of risk of exposure to water-borne illness. This serves as a challenge for public health professionals who are tasked with educating residents about the health benefits and risks associated with drinking tap water, wherein coastal residents not concerned with water quality/availability may view this information as unnecessary. Generally, obtaining a deep understanding of place-based knowledge around health-related issues, as done here, has the potential to impact future policy and management-level decisions and lead to meaningful integration of local perspectives.