Since the establishment of the first national park (Yellowstone National Park in 1872) and the first wildlife refuge (Pelican Island in 1903), dramatic changes have occurred in both ecological and cultural landscapes across the U.S. The ability of these protected areas to maintain current levels of biodiversity depend, at least in part, on the integrity of the surrounding landscape. Our objective was to quantify and compare the extent and pattern of natural land cover, risk of conversion, and relationships with demographic and economic variables in counties near National Park Service units and U.S. Fish and Wildlife Service refuges with those counties distant from either type of protected area in the coterminous United States. Our results indicate that landscapes in counties within 10 km of both parks and refuges and those within 10 km of just parks were more natural, more intact, and more protected than those in counties within 10 km of just refuges and counties greater than 10 km from either protected area system. However, they also had greater human population density and change in population, indicating potential conversion risk since the percent of landscape protected averaged < 5% in both groups and human population dynamics are primary drivers of change in many landscapes. Conversion outweighed protection by at least two times (Conservation Risk Index > 2) in 76% of counties near both parks and refuges, 81% of counties near just parks, 91% of counties near just refuges, and 93% of distant counties. Thirteen percent of counties in the coterminous U.S. had moderate to high amounts of natural land cover (> 60%), low protection (< 20%), and the greatest change in population (> 20%). Although these areas are not the most critically endangered, they represent the greatest conservation opportunity, need, and urgency. Our approach is based on national level metrics that are simple, general, informative, and can be understood by broad audiences and by policy makers and managers to assess the health of lands surrounding parks and refuges. Regular monitoring of these metrics with satellite data products in counties surrounding protected areas provides a consistent, national level assessment of management opportunities and potentially adverse changes on adjacent lands.