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Property and Equipment (Tables) | 12 Months Ended
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Dec. 31, 2020
Property, Plant and Equipment [Abstract] |
Property, Plant and Equipment | At December 31, property and equipment consisted of the following:
| 2020 |  | 2019
Land | $ | 226.8 |  |  | $ | 169.5 |
Buildings | 7,326.1 |  |  | 7,067.3 |
Equipment | 8,560.9 |  |  | 7,913.3 |
Construction in progress | 2,138.8 |  |  | 1,884.4 |
| 18,252.6 |  |  | 17,034.5 |
Less accumulated depreciation | (9,570.7) |  |  | (9,161.6) |
Property and equipment, net | $ | 8,681.9 |  |  | $ | 7,872.9 |
Depreciation expense related to property and equipment was as follows:
| 2020 |  | 2019 |  | 2018
Depreciation expense | $ | 765.2 |  |  | $ | 814.7 |  |  | $ | 797.1 |
Long-lived Assets by Geographic Areas | The following table summarizes long-lived assets by geographical area:
|  |  |  | 2020 |  | 2019
Long-lived assets(1): |  |  |  |
U.S. and Puerto Rico |  | $ | 6,113.6 |  |  | $ | 5,595.4 |
Ireland |  | 1,786.9 |  |  | 1,454.8 |
Other foreign countries |  | 1,747.7 |  |  | 1,758.3 |
Long-lived assets |  | $ | 9,648.2 |  |  | $ | 8,808.5 |
(1) Long-lived assets consist of property and equipment, net, operating lease assets, and certain other noncurrent assets.

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- Definition Tabular disclosure of long-lived assets, excluding financial instruments, long-term customer relationships of a financial institution, mortgage rights, deferred policy acquisition costs, and deferred tax assets, by geographic areas located in the entity's country of domicile and foreign countries in which the entity holds assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 41 -Subparagraph b -URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599 + Details
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- Definition Tabular disclosure of physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, balances by class of assets, depreciation and depletion expense and method used, including composite depreciation, and accumulated deprecation. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02(13)) -URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6391035&loc=d3e2868-110229 + Details
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