Hawaii is facing a severe health care worker shortage — a “wake-up call” that will take solutions from all sectors, from incentives by private health-care companies, to proactive state policies and funding, to better educational pipelines.

Since the beginning of the pandemic, there has been a 76% increase in unfilled health-care job openings, from 2,200 in 2019 to 3,873 this year, the Healthcare Association of Hawaii (HAH) reports. Nearly 1,000 registered specialty nurses are needed; more than 700 positions for certified nursing assistants and nurse aides are open.

With a current job vacancy rate of 17%, compared with 10% in 2019, this an urgent problem.

Health-care providers need to make a cost-benefit analysis of their hiring patterns: Do Hawaii’s wage-and-benefit offerings give the state’s youth a reason to plan a career in the field and in the islands?

In Hawaii, affordable housing is the top concern for would-be health-care workers, and workers have been pushing for compensation that reflects the high costs of living. It’s up to Hawaii’s health-care providers, along with the insurers who moderate their income, to account for this.

Preventive health-care offerings such as gym memberships and wellness classes can also be a tool to keep more of Hawaii’s residents from developing serious illness. Effective offerings should be expanded, as should access to mental health services.

Those who share concern about health-care costs, including employers, can participate in reducing medical needs by promoting public wellness, pursuing preventive measures against chronic conditions such as obesity, diabetes and kidney disease, and advocating for a healthy environment.

However, it’s also an unavoidable fact that Hawaii’s population is aging, and elderly patients are increasingly likely to need extended health-care services, overburdening hospitals and making the medical worker shortage more pronounced.

To address the need, state and county governments must play a part. The best strategy here is to nurture Hawaii’s educational pathways toward these careers.

The Healthcare Workforce Initiative, a volunteer group of leaders in various sectors, has been doing just that, supporting partnerships with community colleges and even high schools to get students into entry-level certification programs.

Another promising pilot program allows certified nurse aides to continue working while taking classes at their workplace to become licensed nurse practitioners, advancing their careers. This kind of tailored incentive to advance for homegrown health-care workers is encouraging, as is expansion of nurse residency and “transition-to-specialty” programs for registered nurses.

There also is need to pump up training programs outside of Oahu — particularly on Lanai and Maui, which have the highest percentage of job openings. This year, $1.75 million in state funds was directed to the University of Hawaii to hire additional nursing instructors; that’s a step in the right direction.

Federal assistance can help, as well. UH last week announced a $1 million federal grant to support a new UH Rural Health Research & Policy Center. Staffers here are crunching data and seeking out sources of federal funds, including improved Medicare payments, to help fill Hawaii’s particular needs.

Traveling health-care workers have been filling the gap, and HAH is seeking an extension of the state’s emergency rules authorizing out-of-state nurses to temporarily practice in Hawaii. This should be granted — but it must be understood that using temporary, fly-in nurses is no permanent solution. That will take true and prolonged investment in growing and keeping medical workers here, plus preventative incentives to help Hawaii’s people stay healthy.