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.