Research is increasingly showing that land-based nutrients (from agriculture, sewage, and livestock rearing) and sediments can compromise coral health and reduce coral resilience to climate change impacts. However, the role of land-based pollution in the widespread loss of corals remains underexplored due to a lack of reef water quality monitoring. Working in the Caribbean, we are working to track long-term land use changes through remote sensing analysis and link them to coral health, water quality, and reef ecosystem functioning over the past century.