Rural Tasmania led the nation in loss of farm income over the recent drought yet the health effects there were scarcely noticed by national media and even climate change and health research. Even in areas such as rural Tasmania with relatively benign climate predictions, climate change may bring disproportionately negative health impacts in communities already socio-economically stressed and with unequal health service access. Research that supports local health service adaptation actions for vulnerable groups can do much to reduce the rising health burden of climate change. How should rural communities evaluate the health impacts and risks of climate change and engage with such complexities? This presentation explores the results of a completed pilot Tasmanian project, funded by the Office of Climate Change, which has developed an online health impact and risk assessment (HIRA) tool for rural communities. It analyses the strengths and weaknesses for rural communities of emerging international HIRA approaches developed by agencies such as the UK’s Climate Impacts Programme. It describes the rationale and nature of the 2011-2012 Tasmanian pilot study which tested an online whole-of-community health impact and risk assessment tool in three rural local government sites. It explores the key theoretical and technical features of our online pilot tool integrating local area climate science predictions and local impact/risk assessments as part of a translational research approach for community health planning and development. It concludes with an exploration of critical methodological challenges in preparing rural communities for the health challenges of climate change. We argue that current efforts to develop local area climate science projections on smaller ‘grids’, ostensibly for community decision-makers, are unlikely to be valuable without sophisticated translational research techniques for transforming those scientific projections into informed community adaptation priorities and strategies, especially in health.