Climate change and its associated extreme heat is one of the greatest risks to public health today. The sharp increase in mortality during the June 2021 British Columbia (BC) heat dome revealed inequities further exacerbated by the social and structural determinants of health. The fundamental causes of health injustices are well-established; however, contemporary solutions, such as increasing access to greenspace, require decisionmakers to pay close attention to structural and political determinants that continually perpetuate negative health outcomes. By conducting a social autopsy of the community deaths from the BC heat dome, we illustrate how material deprivation, social isolation, and access to greenspace are key risk factors that are the result of longstanding colonial legacies. Without paying close attention to this relationship, climate-health response risks further exacerbating inequities.