Climate change intensifies existing health inequities by compounding the social and structural conditions that shape exposure, vulnerability, and recovery. Health impact assessment (HIA) is increasingly used to inform climate and resilience decision-making, yet it remains unclear whether these assessments meaningfully address racial equity in the United States, where structural racism is a major driver of environmental and health disparities. This study evaluated the extent to which climate- and resilience-related HIAs incorporate racial and ethnic equity and identified patterns distinguishing stronger from weaker equity-oriented HIA practice. We conducted a document review of climate- and resilience-related HIAs identified through the Institute for People, Place, and Possibility repository. Of 33 records retrieved, 31 met inclusion criteria. Each HIA was independently scored by two reviewers using the Tool for the Racial/Ethnic Equity Evaluation of Health Impact Assessments (TREE-HIA), a 17-item rubric spanning six domains: community engagement, scope and context, analysis/evidence, recommendations, dissemination, and monitoring and evaluation. We then performed a reflexive thematic analysis of the four highest- and four lowest-scoring HIAs using a deductive codebook informed by co-benefits of climate action and Public Health Critical Race Praxis. Most HIAs (23/31; 74%) received negative TREE-HIA scores, indicating inconsistent integration of equity across the HIA process. Thematic analysis identified four distinguishing themes: whether race was treated as a demographic descriptor or as a marker of structural inequity; whether co-benefits were framed in race-neutral or equity-specific terms; the extent and depth of community voice in the assessment process; and whether an intersectional lens was applied. These findings suggest that most U.S. climate- and resilience-related HIAs do not adequately account for racial/ethnic equity. Strengthening HIA practice will require explicit attention to structural racism, deeper participatory engagement, and greater use of intersectional and justice-oriented frameworks to support equitable climate resilience policy.