The Sustainable Development Goals, while complex at first sight, express a simple narrative about the relationships between people and nature. This paper illustrates this in the context of a coral reef land or seascape supporting coastal people. Coral reefs, their health described by measures of coral and fish diversity and abundance, provide key services and benefits to people. These services directly support 10s of millions of jobs in multiple economic sectors in coastal and distant states, protect and harbor communities and cities across tropical coastlines, sustain use of living and non-living resources, provide transport infrastructure and valuable natural products, and in future may provide energy solutions. Through these multiple benefits, coral reefs contribute to reducing hunger and poverty, thus improving health, and potentially strengthening gender and social equality. However, access and use result in pressures that may drive decline in coral reef health. Broader land and seascape factors also affect reef health, including land-use change and altered freshwater flows, as well as climate change. Managing this complex system requires appropriate awareness and knowledge, governance mechanisms and investments by stakeholders. This narrative can be used from local to global levels, motivating actions and policy at and across these scales to sustain ecosystem function and use, for the oceans what is also increasingly called a blue economy.