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. This restructuring has resulted in social changes with major implications for the health and well-being of individuals and communities. This study examines the relationship between socio-economic restructuring and health in four BC coastal communities by a community health survey and in-depth interview studies. The findings of the survey analyses indicate that the communities lag behind the province of British Columbia and Canada as a whole in terms of self-reported health status. 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. Differences in health status are plausibly attributable to restructuring processes and major events in each community. 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.