The Ecological Research, Assessment and Prediction's Tidal Creeks: Sentinel Habitat Database was developed to support the National Oceanic and Atmospheric Administrations' (NOAA) Hollings Marine Laboratory (HML) Oceans and Human Health Initiative (OHHI). The goal of the program is to provide the scientific information and framework for forecasting environmental and human health risks across estuarine habitats, watersheds, and regions which includes the testing of new technologies developed by other HML OHH groups. This includes a wide range of data from tidal creek systems which are being used as the sentinel habitat for assessing and predicting the impact of coastal development on estuarine systems. Sampling has occurred in South Carolina, Georgia, North Carolina, Alabama, and Mississippi. Historical data from 1994, 1995, 2000 as well as recent data from 2005, 2006, and 2008 are included in the database. A wide range of parameters have been sampled in the estuarine tidal creek systems and their watersheds to obtain data on water quality (e.g., nutrients, pathogens, dissolved oxygen, salinity), sediment quality (e.g., characteristics, chemical contaminants), biological condition (e.g., macrobenthos, fish, organism health) , human exposure (e.g., pathogens), and watershed attributes (e.g., land cover, impervious cover, demographics). Each creek was sampled from its headwaters to its junction with a large open estuary. The creeks represented the range of land use types and human uses that occur in the Southeastern and Gulf regions, including forested, suburban, and urban watersheds. Results of these studies indicate that the amount and type of watershed development are linked to changes in creek environmental quality including increased fecal coliform levels, decreased sediment quality, changes in the kinds and abundances of biota, changes in the abundance of juvenile fish, and decreases in the abundance of shrimp that use these habitats as nurseries. These findings suggest that the shallow estuarine habitats that form the primary link with the land provide early warning of impairment and may be sentinels of ensuing harm from land-based activities. The levels of microbial and chemical contamination in these headwater environments are frequently an order of magnitude greater than that reported for deeper open water environments. Shallow or headwater tidal creeks are, in effect, the "first responders" to impacts of non-point source pollution runoff.