This research explored nonclimatic determinants that influence how indigenous people experience, understand and respond to climate-related health outcomes. It concentrated on place-based dimensions of vulnerability and broader determining factors. The majority of data were from Australia and the Arctic and indicated significant adaptive capacity, with active responses to climate-related health risks. However, this adaptability is challenged by co-existing nonclimatic stresses including poverty, land dispossession, globalisation, and associated sociocultural transitions. The article concludes that key foci for future research include addressing geographic gaps, a greater focus on indigenous conceptualisations and approaches to health, examination of global–local interactions shaping local vulnerability, enhanced surveillance, and an evaluation of policy support opportunities.