Only three of the 74 Chinese cities monitored by the central government met the national standard for “fine air” — meaning healthy air — in 2013, according to a report this week from the Environmental Protection Ministry. The three cities are in remote areas, including Lhasa, the capital of Tibet. The dirtiest cities, including Beijing, are in northern China, where coal-fired industries are concentrated; the Yangtze Delta in the east; and the Pearl River Delta in the south. A former health minister, Chen Zhu, has estimated that 350,000 to 500,000 people die prematurely as a result of air pollution each year.

The report provides especially dramatic evidence of what the world and the Chinese people have long known — that China has a huge air pollution problem arising mainly from a policy of industrializing first and cleaning up later.

To its credit, China has been making serious efforts to foster renewable energy, studying and seeking to emulate the environmental policies of the advanced economies. One quarter of China’s electricity-generating capacity now derives from wind, solar and hydroelectric sources. But rapid economic growth has not diminished the nation’s appetite for fossil fuels, and while the government is moving to tighten pollution standards on vehicles, many Chinese automobiles are using cheaper and dirtier gasoline than that allowed in Western countries.

China is not alone. Around the world, the World Health Organization reports, air pollution contributed to seven million deaths in 2012, with more than a third of those occurring in fast-developing nations like India. Yet the situation in China is so dire that Prime Minister Li Keqiang announced this month a “war on pollution.” Mr. Li acknowledges the need to find a balance between economic growth and environmental protection. China still needs to elevate several hundred million people out of poverty and into the middle class. But it is past time for China’s leaders to think of growth in the long term and in a comprehensive manner, factoring in the human and economic costs of millions of pollution-related illnesses and deaths.