Human impacts on sand-producing, large benthic foraminifers were investigated on ocean reef flats at the northeast Majuro Atoll, Marshall Islands, along a human population gradient. The densities of dominant foraminifers Calcarina and Amphistegina declined with distance from densely populated islands. Macrophyte composition on ocean reef flats differed between locations near sparsely or densely populated islands. Nutrient concentrations in reef-flat seawater and groundwater were high near or on densely populated islands. d15N values in macroalgal tissues indicated that macroalgae in nearshore lagoons assimilate wastewater-derived nitrogen, whereas those on nearshore ocean reef flats assimilate nitrogen from other sources. These results suggest that increases in the human population result in high nutrient loading in groundwater and possibly into nearshore waters. High nutrient inputs into ambient seawater may have both direct and indirect negative effects on sand-producing foraminifers through habitat changes and/or the collapse of algal symbiosis.