Health poverty alleviation is an important project of people's livelihood in our country. It is of great significance to pay attention to the achievement and influencing factors of health poverty alleviation in the general environment. Based on the CFPS data, this study firstly analyzed the prevalence rate of chronic diseases in the poor middle-aged population of our country from 2010 to 2020, the self-rated health of the middle-aged poverty group and its influencing factors in 2020 CFPS data were analyzed based on the theory of social ecosystem. The results showed that, at the micro level, the influencing factors were the habit of lunch break, positive emotion and higher educational background, at the middle level, the influencing factors were the poor medical treatment level and the good trust degree to the doctors at the hospital, and at the macro level, it is believed that the employment problem is not serious and has a significant positive effect on the self-rated health of the poor middle-aged group. Therefore, the logic of health-based poverty alleviation can be constructed from three aspects: individual participation, social support and policy optimization.