The body of literature investigating the causes of vector borne disease (VBD) outbreaks (such as Ross River virus) in coastal subtropical regions of Australia, stresses that the relationship between VBD and the biophysical environment, including climate variability and change, is not simple. This paper provides an integrated exploration of VBD incidence in the context of socio-biophysical interactions (such as population dynamics, human settlement growth and biophysical change). The study focuses specifically on the coastal subtropical regions of southeast Queensland and northeast New South Wales. These regions (i) possess the natural landscapes that are conducive to mosquito habitats, (ii) are exposed to climatic conditions favourable to VBD such as Ross River virus, and (iii) are experiencing rapid and continuing population growth, significant urban development, and consequential environmental modification. Together, the emerging socio-biophysical circumstances raise questions as to the future risks of VBD incidence in the region. Options for mitigative and adaptive planning tools and strategies for the sustainable management of such diseases in urban subtropical coastal zones are discussed.