This report documents climate change impacts and potential impacts as described by the local people and interpreted through the lens of public health. It is the sixth report in a series describing climate change across Alaska, and the first report to focus on the Bristol Bay Region. In the Yupik and Aleut community of Pilot Point residents report changes to the weather, landscape, plants and wildlife. Extreme weather events are thought to be more common, the timing of seasons is more unpredictable, erosion to shorelines is occurring at a rapid rate, and consequentially, vulnerability to flooding is increasing. Identified health concerns include food security, damage to health-critical infrastructure, injury and behavioral health issues related toextreme and unusual weather conditions.