Managing the effects of anthropogenic disturbance on coral reefs is highly dependant on effective strategies to assess degradation and recovery. We used five years of field data in the US Virgin Islands to investigate coral reef response to a potential gradient of stress. We found that the prevalence of old partial mortality, bleaching, and all forms of coral health impairment (a novel category) increased with nearshore anthropogenic processes, such as a five-fold higher rate of clay and silt sedimentation. Other patterns of coral health, such as recent partial mortality, other diseases, and benthic cover, did not respond to this potential gradient of stress or their response could not be resolved at the frequency or scale of monitoring. We suggest that persistent signs of disturbance are more useful to short-term, non-intensive (annual) coral reef assessments, but more intensive (semi-annual) assessments are necessary to resolve patterns of transient signs of coral health impairment.