There has been significant interest in the rhetoric of health security in recent years from both global and local perspectives. Understanding health in the context of disaster vulnerability presents an opportunity to examine how improved health might reduce the effects of environmental disasters and other crises. To this end, a project was implemented in Bangladesh to establish the potential of a health security approach for disaster resilience amongst people living in high risk environments. This paper explores what we might mean by health security through engaging community level perspectives in the southeast coastal belt of Bangladesh, an area prone to cyclone and flood. This has been examined with respect to variation in gender and wealth of households. Household surveys, interviews and focus group discussions were some of the methods used to collect data. The findings show that health related coping strategies and agentive capabilities in the context of impending crises vary from one micro-context to the next. This suggests a dynamic and integrative resilience that could be built on further, but one which remains remote from wider discourses on health security.