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This paper describes a decision-support system based on landscape ecology and focused on the study of ecosystems' health. System capabilities are illustrated with three cases of integrated coastal zone management (ICZM), in the Adriatic Sea (Italy): the lagoon of Venice and the Rimini and Ancona coastal areas. Indicators and indices are developed with a focus on sub-regional and local problems in coastal management, with a multi-scale approach based on landscape and seascape ecology. Land-use changes of the coastal areas were detected by analyzing two sets of satellite images. Indices combining satellite imagery, socio-economic and environmental indicators, and landscape and seascape maps were created, showing ecological changes, habitat loss and gaps in conservation policy. The approach used provides means for the identification of conflicts and for the assessment of sustainability. Results show that the lagoon of Venice plays an important role in mitigating and compensating the impacts of human activities, and needs to be protected and restored. The Rimini area shows high ecological footprint and development-intensity and low biocapacity. The Ancona area needs the protection of its natural coastal space from potential sources of anthropogenic impacts to maintain its sustainability. A model of environment changes is critical for formulating effective environmental policies and management strategies. The developed decision-support system provides a suitability map per each area analyzed, which can be used in order to maximize different policy objectives and reduce coastal conflicts. [ABSTRACT FROM AUTHOR]