The objective of this study is to create a comprehensive and integrative tool, using established and innovative measures of health (traditional knowledge, community monitoring, medical and pathological data) and stress (blubber cortisol, stress related proteins, skin microbiomes), for culturally and economically important Arctic marine mammals. By utilizing archival and current data and samples, this cross-disciplinary approach will enable a predictive assessment of adaptation to future regional ecological and climactic change, and economic development. Marine mammals are apex predators in the Arctic and sentinels for the ecosystem as a whole. Narwhal summer in areas of north Baffin Island (Pond Inlet & Arctic Bay) that are being affected significantly by climate change and resource development, yet we lack knowledge of past and current health markers which could facilitate evidence based policy decisions in this area. Proof of concept for this health index will be developed using archived narwhal tissues (1982-2013), field samples collected in collaboration with hunters (2013-2017), community focus groups, hunter and elder interviews. Data will be measurable against recorded climate parameters, and resource development activity in specific areas such as Milne Inlet. Preliminary data on hematology, serum chemistry and respiratory tract flora are presented from live whales captured for telemetry studies conducted over a 10 year period. While no food safety issues were identified, a pathology survey of harvested whales provided by the Mittimatalik Hunters and Trappers Association, documented respiratory pathology and neoplasia. Analysis of corticosteroid levels in blubber, and skin microbiomes are underway. We believe this new health assessment index will help policy makers and communities to promote economic development in an environmentally sustainable manner by providing evidence of stable or changing health status earlier than reliance on crude measures of mortality or changing biological indices.