Important development partners encouraged and supported the development of Caribbean islands’ recent action plans and targets on climate change and health. These developments are part of larger global trends around mainstreaming climate change adaptation into national health policy. Including community voices is crucial, yet the responsiveness of regional and national processes around climate change adaptation and health governance to local community concerns is poorly understood. This case study in rural Trinidad and Tobago sought to contribute to better understanding community led action on health and climate change adaptation by investigating community groups’ perceptions of the challenges faced and addressed by their community. The study contributes to climate change adaptation and health debates in three main ways. First, it develops a conceptual framework around agency in the context of health and climate change adaptation in community groups and local spaces. Second, it fills a gap in the literature by registering the voices and perspectives of coastal community groups regarding their development priorities in the context of climate change adaptation and health. Third, using the lens of agency, it highlights the disconnect between local voices and the urgency around the mainstreaming of climate change adaptation and health into regional and national climate change adaptation policies. This study contributes to wider debates around the power of external agents to shape local discourses and policy. The results contrast dominant global narratives underlying recent regional and national policies and suggest that this area is still one where there may be a disconnect between local development priorities and international policy.
