BackgroundGlobal climate change poses a significant challenge in contemporary society, particularly affecting vulnerable populations like small farmers residing in arid and semiarid regions. This study aims to investigate the perception of health risks and adaptive responses in the semiarid region of Northeast Brazil (NEB). Four questions were formulated: (1) How do socioeconomic factors influence the perception of health risks during extreme climate events? (2) How do socioeconomic factors impact the adoption of adaptive responses to mitigate health risks during extreme weather events? (3) How does the perceived risk level affect the utilization of adaptive responses? (4) What is the influence of extreme climate events on the perceived risks and the adoption of adaptive responses?MethodThe research was conducted in the rural community of Carão, situated in the Agreste region of the State of Pernambuco, NEB. Semi-structured interviews were conducted with 49 volunteers aged 18 and above. The interviews aimed to gather socioeconomic information, including sex, age, income, access to healthcare services, family size, and education level. Additionally, the interviews explored the perceived risks and responses employed during different extreme climate events such as droughts or heavy rainfall. The perceived risks and adaptive responses data were quantified to address the research questions. Generalized linear models were employed to analyze the data for the first three questions, while the nonparametric Mann–Whitney test was used for the fourth question.ResultsThe study found no significant differences in the level of perceived risk and adaptive responses between the two climate extremes. However, the quantity of adaptive responses was found to be directly influenced by the perceived risks, regardless of the type of extreme climate event.ConclusionThe study concludes that risk perception is influenced by various complex factors, including socioeconomic variables, and plays a critical role in the adoption of adaptive responses during extreme climate events. The findings suggest that specific socioeconomic variables have a more pronounced influence on how individuals perceive and adapt to risks. Furthermore, the results indicate a cause-and-effect relationship between perceived risks and the generation of adaptive responses. These findings contribute to a better understanding of the factors shaping risk perception and provide valuable insights for future studies in regions prone to extreme climate events.