New York ? Greeting-card and novelty companies call them “Over the Hill” products: the 50th Birthday Coffin Gift Boxes featuring prune juice and anti-aging soap; the “Old Coot” and “Old Biddy” bobblehead dolls; the birthday cards mocking the mobility, intellect and sex drive of the no-longer-young.

Many Americans chuckle at such humor. Others see it as offensive, as one more sign of pervasive ageism in America.

It’s a bias some also see in substandard conditions at nursing homes, in pension-plan cutbacks by employers, in the relative invisibility of the elderly on television shows and in advertisements.

“Daily we are witness to, or even unwitting participants in, cruel imagery, jokes, language, and attitudes directed at older people,” contends Dr. Robert Butler, president the International Longevity Center-USA and the person who coined the term “ageism” 35 years ago.

That ageism exists, in a society captivated by youth culture and taut-skinned good looks, is scarcely debatable. But as the oldest of the 77 million baby boomers approach their 60s, the elderly and their concerns will inevitably move higher on the national agenda.

‘Smarter, richer, healthier’

Already, there is lively debate as to whether ageism will ease or grow worse in the coming decades of boomer senior citizenship. Erdman Palmore, a professor emeritus at Duke University who has written or edited more than a dozen books on aging, counts himself — cautiously — among the optimists.

“One can say unequivocally that older people are getting smarter, richer and healthier as time goes on,” Palmore said. “I’ve dedicated most of my life to combating ageism, and it’s tempting for me to see it everywhere. … But I have faith that as science progresses, and reasonable people get educated about it, we will come to recognize ageism as the evil it is.”

Palmore, 74, lives what he preaches: challenging the stereotypes of aging by skydiving, whitewater rafting, bicycling his age in miles each birthday.

Maggie Kramer, 68, left, and Nicholas Donoghoe, 23, work together at a program in Baltimore that pairs students from Johns Hopkins Medical School with elderly people. The Vital Visionaries Collaboration, sponsored by the National Institute On Aging, was intended to give medical students a more positive image of older people and encourage them to consider geriatrics as a speciality.

“What makes me mad is how aging, in our language and culture, is equated with deterioration and impairment,” Palmore said. “I don’t know how we’re going to root that out, except by making people more aware of it.”

More and more targets

To the extent that ageism persists, there will soon be many more potential targets. The number of Americans 65 and older is projected to double during the next three decades from 35.9 million to nearly 70 million, comprising 20 percent of the population in 2030 compared with less than 13 percent now.

The 85-and-over population is the fastest growing segment, projected to grow from 4 million in 2000 to 19 million in 2050 as part of an unprecedented surge in longevity. Americans now turning 65 will live, on average, an additional 18 years.

Attitude and longevity

Some researchers believe that ageism, in the form of negative stereotypes, directly affects longevity. In a study published by the American Psychological Assn., Yale School of Public Health professor Becca Levy and her colleagues concluded that old people with positive perceptions of aging lived an average of 7.5 years longer than those with negative images of growing older.

Levy said many Americans started developing stereotypes about the elderly during childhood, reinforced them throughout adulthood, and entered old age with attitudes toward their own age group as unfavorable as younger people’s attitudes.

Hazel Lueders, 74, receives help from palliative care specialist and nurse Vicki Boehmer before being discharged from Missouri Baptist Medical Center in St. Louis for treatment of pneumonia. The hospital is among those trying to improve health care programs for elderly patients.

Job discrimination

For thousands of American workers, it’s the same message they claim to hear on the job. The U.S. Equal Employment Opportunity Commission has received more than 19,000 age- discrimination complaints in each of the past two years, and has helped win tens of millions of dollars in settlements.

However, attorneys say age discrimination often is hard to prove. Only about one-seventh of the EEOC age cases were settled to the complainant’s benefit.

New Yorker Bill DeLong, 84, was fired three years ago from his longtime job as a waiter at a Shea Stadium restaurant, but he continues to seek out charitable volunteer assignments and still works as a waiter occasionally at special events.

“I didn’t give up,” he said. “A lot of my contemporaries give up too soon.”

Health care concerns

For many older people, ageism surfaces most painfully in the context of health care. A report by the Alliance for Aging Research, presented to a Senate committee last year, said the elderly were less likely to receive preventive care and often lacked access to doctors trained in their needs.

Only about 10 percent of U.S. medical schools require work in geriatric medicine. The American Geriatrics Society says there are only about 7,600 physicians nationwide certified as geriatric specialists, not enough to meet demand and far below the 36,000 the society says will be needed by 2030.

While the society says the best way to attract more doctors to the field is to make Medicare practice more lucrative, some experts believe that many medical students also have negative attitudes toward the elderly that should be challenged.

In one such effort, the National Institute on Aging, working with Johns Hopkins Medical School and a Baltimore museum, teamed elderly people and first-year medical students in an art program in which they drew, made collages, sang songs and shared stories. A survey showed the students gained a more positive view of seniors and of geriatrics as a possible specialty.

Advertising bias

Ageism also manifests itself in advertising. Though adults of all ages drink beer and buy cars, for example, TV and print ads for those products almost invariably feature youthful actors and models.

According to AARP, the lobbying group for people 50 and over, Americans in that age bracket account for half of all consumer spending but are targeted by just 10 percent of marketing.

John Rother, policy director for the AARP, said the boomers, by their very numbers, are bound to change the public perception of aging.

“It will be more visible,” he said. “People will survive longer, in better health. … They’ll feel the market should cater to them, the political system should cater to them, as it has their whole lives.”