Coral reefs are critically important habitats that provide structure and food to millions of marine flora and fauna, as well as food, jobs, and coastal protection to hundreds of millions of people. Despite their value, coral reefs have experienced a global decline due to overfishing, pollution, and warming oceans that are becoming increasingly acidic. To help halt and reverse this decline, we must evaluate our current efforts, address major gaps, increase return on investment, and engage new partners. My dissertation identifies a chronic threat to coral reefs, coastal pollution, that has been relatively underappreciated for its potential impact and largely neglected by the conservation community. I also show that coral reefs and people in tropical coastal areas face many of the same threats, and using sewage pollution as an example, propose a new collaboration between the human health and coral reef conservation sectors to address this ignored threat. From reef practitioner surveys (Ch. 1), I found that coral reef practitioners consistently rank overfishing and coastal development as the two top threats locally, but are investing at least twice as many resources in addressing overfishing relative to coastal development. This mismatch in allocation of resources was consistent across geographies and present in all organization types surveyed. In my literature review of sewage pollution impacts on coral reefs (Ch. 2), I found the impacts of sewage pollution to be generally assumed to be negative but with no experimental investigations or rigorous comparisons support this assumption. Consequently, I focused on the most common components of sewage and found a wide range of negative impacts on corals associated flora and fauna, leading me to conclude that sewage should be considered a multi- rather than single stressor in conservation threat frameworks. Additionally, I found that 104 of the 112 coral reef geographies are impacted by some degree of sewage pollution, emphasizing the global extent of the threat. In my literature review on threats to human and coral reef health (Ch. 3), I demonstrate that people and coral reefs share at least 9 serious threats, with at least half being related to pollution. I then highlight that sewage pollution presents an opportunity to galvanize the coral reef conservation and human health sectors to join forces in battling this deadly problem. Recent marine conservation and management practice has emphasized marine protected areas (MPAs) as a primary management tool. However, MPAs do not address key threats to the marine environment (e.g., coastal development and associated pollution). As a whole, this dissertation provides a starting point for natural resource managers and conservationists that are pushing beyond MPAs as a management tool, to begin addressing neglected critical threats that impact both coral reefs and people.