endemic disease transmission is an important ecological process that is challenging to study because of low occurrence rates. Here, we investigate the ecological drivers of two coral diseases-growth anomalies and tissue loss-affecting five coral species. We first show that a statistical framework called the case-control study design, commonly used in epidemiology but rarely applied to ecology, provided high predictive accuracy (67-82%) and disease detection rates (60-83%) compared with a traditional statistical approach that yielded high accuracy (98-100%) but low disease detection rates (0-17%). Using this framework, we found evidence that 1) larger corals have higher disease risk; 2) shallow reefs with low herbivorous fish abundance, limited water motion, and located adjacent to watersheds with high fertilizer and pesticide runoff promote low levels of growth anomalies, a chronic coral disease; and 3) wave exposure, stream exposure, depth, and low thermal stress are associated with tissue loss disease risk during interepidemic periods. Variation in risk factors across host-disease pairs suggests that either different pathogens cause the same gross lesions in different species or that the same disease may arise in different species under different ecological conditions.Disease is an ecologically and evolutionarily important process in shaping populations, communities, and ecosystems 1-5 , but identifying factors that promote disease at low endemic levels or between epidemics is challenging because disease occurrences are rare in space and time. Disease can affect populations, communities, and ecosystems through multiple pathways, such as changing the physiology, behavior, distribution, abundance, and fitness of organisms (e.g. 3,6,7 ). For example, when the trematode Plagioporous sp. infects the coral Porites compressa it reduces coral growth and causes infected polyps to appear as bright swollen nodules that cannot retract into their skeletal cups, thus increasing fish predation and affecting coral physiology, behavior, and fitness 8 . As another example, infection in three-spined sticklebacks by the fish parasite Gyrodactylus spp. has been shown to alter the zooplankton community structure and nutrient cycling in streams and lakes, which in turn, affect the survival and fitness of the subsequent fish generation 5 . Despite the ecological and evolutionary importance of disease, understanding the factors that increase individual disease risk for endemic diseases with low prevalence or during interepidemic periods for diseases with epidemic cycles can be challenging because of the low probability of observing diseased individuals during non-outbreak periods.With limited occurrence data relative to nonoccurrence data, commonly used biostatistics such as logistic regression can significantly underestimate the probability of rare events such as disease occurrence 9 . Further, such models are likely to have high predictive accuracy (proportion of correctly identified event and nonevent observations), which can be mis...