Elderly volunteers are the effective force in the healthy community governance system. Participating in community health volunteer service is an important form to realize the value of the elderly themselves and the society. From the perspective of active aging, this study selects variables from socio-demographic characteristics, family support, social adaptation and other dimensions to investigate the current status of volunteer activities and cognitive level of the elderly in a city community in Nantong and its influencing factors. Through comparative analysis of the elderly volunteers and the general elderly in the community, this paper analyzed the influencing factors of the elderly community health management participation in the form of elderly health volunteer service participation, and explored the relationship between health participation and awareness level. This study found that the cognitive level of the elderly volunteers was higher than that of the general elderly in the community. The elderly aged 60-69 years old were the main force of community health volunteer participation. The elderly with higher education level and living with their children or spouse had higher health volunteer participation. Positive community communication and recreational participation promoted the social participation of the elderly in health volunteer service, but it had not been found that active social participation could effectively reduce the cognitive decline of the elderly. It suggested that the quality of life of the elderly should be further improved, and the elderly should be further promoted to participate in the development of healthy community governance from the three dimensions of macro guarantee, medium support and micro incentive, providing a nice community environment, legal protection and policy basis for the elderly's health voluntary service, so as to strengthen the elderly's participation in community health voluntary service and stimulate their motivation to participate in community health governance.