Global warming is leading to increased frequency and severity of storms that are associated with flooding, increasing the risk to urban, coastal populations. This study examined perceptions of the relationship between severe storms, sea level rise, climate change and ecological barriers by a vulnerable environmental justice population in New Jersey. Patients using New Jersey’s Federally Qualified Health Centers were interviewed after Hurricane [Superstorm] Sandy because it is essential to understand the perceptions of uninsured, underinsured, and economically challenged people to better develop a resiliency strategy for the most vulnerable people. Patients (N = 355) using 6 centers were interviewed using a structured interview form. Patients were interviewed in the order they entered the reception area, in either English or Spanish. Respondents were asked to rate their agreement with environmental statements. Respondents 1) agreed with experts that “severe storms were due to climate change”, “storms will come more often”, and that “flooding was due to sea level rise”, 2) did not agree as strongly that “climate change was due to human activity”, 3) were neutral for statements that “Sandy damages were due to loss of dunes or salt marshes”. 4) did not differ as a function of ethnic/racial categories, and 5) showed few gender differences. It is imperative that the public understand that climate change and sea level rise are occurring so that they support community programs (and funding) to prepare for increased frequency of storms and coastal flooding. The lack of high ratings for the role of dunes and marshes in preventing flooding indicates a lack of understanding that ecological structures protect coasts, and suggests a lack of support for management actions to restore dunes as part of a coastal preparedness strategy. Perceptions that do not support a public policy of coastal zone management to protect coastlines can lead to increased flooding, extensive property damages, and injuries or loss of life.