Climate change is a major public health hazard and a critical component of sustainable development. Understanding public perceptions of these risks is crucial for developing effective local environmental policies that contribute to health and sustainability goals. This research aimed to characterize the perceptions of an adult Portuguese population regarding climate change and its health impact and to examine their awareness of and compliance with municipal policies. The choice of Cascais as a case study reflects its urban character, exposure to climate risks, and its proactive stance in local environmental policy. We conducted research on the environmental programs/guidelines implemented in the urban municipality of Cascais. Subsequently, we employed an online survey to gather data on the perceptions of 200 adults residing/working in Cascais. People with higher awareness are more likely to engage in environmentally conscious behaviors, essential for sustainable development. However, many respondents were unaware of municipal programs and did not participate. Perceptions of climate risk and action priorities varied by sex, age, and education. Improved communication and awareness-raising are needed. This study contributes to the broader understanding of environmental perception by highlighting the influence of demographic factors on climate-related knowledge and behavior. It also demonstrates the value of integrating public perception data into municipal policy planning and sets a replicable framework for comparative research across urban contexts. Incorporating citizens’ perceptions can help municipalities develop effective, community-adapted policies, fostering inclusive and resilient local climate actions to protect public health.

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