The health of Hawaii — or at least its capacity to care for its people — is gradually on the mend. This has been a long-term ailment in the state, where for years patients have struggled to find certain specialized care accessible to them, particularly if they live on islands far from population centers, and even on Oahu.
In 2018 the nonprofit industry group Healthcare Association of Hawai‘i launched its Healthcare Workforce Initiative, which produces a report on the labor issue every two years. And in the new 2024 edition, the group concluded that the state is still short of more than 4,600 health care workers in various categories.
This is not strictly a local crisis. Owing especially to the aging of the baby boomer generation, the private-practice sector has faltered, leaving about 70 million seniors waiting longer for care.
In Hawaii, of course, the problem is exacerbated by the scattering of the population across multiple islands, each patient confronting high transportation costs on top of the shortage of health-care providers generally.
The good news is that according to the workforce initiative, the vacancy rate now stands at 14%, 3% lower than it was in 2022. That still sounds too high — and it is — but considering that the efforts being made to counter the labor shortage are relatively recent, the progress being made is encouraging.
That campaign to improve what health careers have to offer in Hawaii must continue. This includes the Health Care Education Loan Repayment Program. In its first year, the program assisted more than 900 practitioners in primary care and behavioral health professions paying off their medical training debt. In return, they commit to at least two years of service in medically underserved areas here.
But it isn’t only among the medical doctors that there is a problem in recruitment. The COVID-19 pandemic pushed a lot of nurses to burnout, and staffing hasn’t fully recovered.
Recent labor unrest in Hawaii’s nursing sector provides evidence of the lingering shortfall. A three-day strike by 600 nurses and management lockout at Kapi‘olani Medical Center for Women &Children last year underscored the tension surrounding staffing levels.
That ultimately resolved in October with the ratification of a new 3-year contract locking in annual raises for the nurses. But it took more than a year of negotiations to get to that point. The pace of the improvement, as welcome as it is, has to pick up for what’s ahead.
Most recently, the nurses at both Queen’s and Kauai’s Wilcox medical centers have authorized three-day strikes next week, pointing to high patient-to-nurse ratios as being a principal point of contention. The hope is that the parties can come to an agreement more quickly, perhaps taking some positive instruction from the Kapi‘olani experience.
Examining detail in the workforce report illuminates the challenges to overcome. The shortage in skilled- nursing settings is the only category showing an increase in job openings, although acute-care hospitals still have the most vacancies.
It is noteworthy that in its proposal for a new Kona hospital, The Queen’s Health Systems also is proposing building below-market-rate housing, addressing one of the chief obstacles for professionals considering employment in Hawaii. That’s another approach worth replicating.
The new report points to effective strategies in addressing workforce needs, such as better transitioning from training to practice for new nurses. Such successes suggest that with the next report, the prognosis for health care should continue on its upward trajectory.
