Under the macro context of severe global aging, the typical villages and dwellings of the Miao ethnic group in western Hunan were selected, and the daily life and health status of the local elderly were evaluated through behavioral observation, interviews, and questionnaires (e.g., physiological, psychological, and residential environments). In addition, the health status and relevant evaluation factors of the respondents were correlated and then analyzed using SPSS software. As indicated by the results of this study, the local elderly used all the spaces and functions of the existing dwellings and were satisfied with the spaces except for the toilet. In addition, their physiological functions had declined, and their daily behaviors were affected by a wide variety of physical diseases. From a psychological perspective, more than 60% of the elderly had significant feelings of loneliness and frustration. As indicated by the correlation results, the health status of the elderly in traditional Miao dwellings in western Hunan was positively correlated with family, income, daily acts, dwellings, and infrastructure, and negatively correlated with age. They showed linear correlations with all impact factors: Health = 157.44 − 5.242 ∗ Gender − 1.611 ∗ Age − 0.606 ∗ Education level − 0.411 ∗ Family + 0.001 ∗ Income − 7.191 ∗ Daily acts + 13.621 ∗ Dwelling + 4.682 ∗ Infrastructure + 17.198 ∗ Natural. Based on the results of study, targeted improvement strategies were proposed for the elderly in traditional Miao dwellings in western Hunan from four aspects—infrastructure, traditional dwellings, mental health, and policy support—to improve the health status of the elderly in traditional Chinese villages and towns.