Floods, windstorms, drought and wildfires have major implications for human health. To date, conceptual advances in analysis of vulnerability and adaptation to climatic hazards from the environmental and social sciences have not been widely applied in terms of health, though key progress is being made particularly in relation to climate change. This paper seeks to take this conceptual grounding further, examining how key themes relate to health concerns, exploring connections with existing health literatures, and developing an organising framework to aid analysis of how vulnerability to health impacts varies within society and how actors make decisions and take action in relation to climatic hazards and health. Social science research on this theme is challenging in part because of the complex mechanisms that link hazard events to health outcomes, and the many-layered factors that shape differential vulnerability and response within changing societal and environmental contexts (including the dual effect of hazards on human health and health systems, and the combination of `external', `personal' and `internal' elements of vulnerability). Tracing a `health impact pathway' from hazard event through health risk effects to health outcomes can provide a research tool with which to map out where the different factors that contribute to vulnerability/coping capacity come into effect. (c) 2006 Elsevier Ltd. All rights reserved.